Omolola Santiago
Houston,TX
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening, and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, and providing customized solutions to build loyalty.
Overview
6
6
years of professional experience
Work History
Customer Service Representative (member services)
Blue Shield of California (TTEC)
11.2022 - Current
- Answering incoming calls regarding resolving medical and pharmacy benefit inquiries in respect to copays and deductibles on the policy.
- Resolving claim-related questions about member’s medical and pharmacy claims using CVS-COS
- Resolving claim-related inquiries from health providers by faxing the Explanation of Benefits
- Researching prior authorizations using Auth Accell and advising of status and further solutions if denied.
- Coordinating with health care provider offices to fax in prior authorization for medical or pharmacy related inquires
- Providing alternatives to drugs by checking the formulary to see what is available to members
- Resolving inquiries regarding vacation overrides for prescription medication by coordinating with local pharmacies to authorize them.
- Assisting with plan changes during open enrollment and qualifying events.
- Referred new customers to sales for enrollment after inquiries about the plan Blue Shield of California offers
- Resolving eligibility issues/inquiries in regards to confirmation of Coverage, reinstatement of policies, and termination of policies using Shield Advisor and Facets
- Processing premium payments and setting up automatic payments over the phone.
- Adding third-party authorizations using Powr
- Filling appeals and grievances for member who are not satisfied with how their claims were processed.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Assisting and resolving technical issues related to members' online portal on the Blue Shield of California website
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Consistently meeting my targets concerning QAs, Average handle time, After-call work, and Surveys.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Keeping up with the compliance claims and internal training.
Receptionist
Memorial Hermann Hospital
08.2021 - 11.2022
- Greeting and checking in patients into the emergency center
- Checking in visitors and writing passes for visitors to visit their loved ones
- Confirmed appointments, communicated with clients, and updated client records.
- Rounding up on patients in the emergency room by asking if they need anything and if they have been attended to or triaged
- Receiving incoming calls from visitors or patients making inquiries
- Making outbound calls to family members who want to visit their loved ones
- Maintained a well-organized reception area with updated materials, contributing to a welcoming environment for visitors.
- Updating the visitors' management tool
- Resolved customer problems and complaints.
- Checking in patients for surgery and Patient testing
- Following protocols and procedures regarding keeping patient information confidential according to the hospital and HIPAA.
Collection Representative/agent
Convergent Outsourcing Incorporated Houston Texas
07.2020 - 09.2020
- Received incoming calls and processed payments for consumers who were late and wanted to settle their accounts
- Made outbound calls to consumers to settle their late accounts and worked with them to set up a payment plan to close the account
- Ensured timely follow-up on outstanding accounts, minimizing potential losses due to non-payment or delayed payments.
- Negotiated favorable settlements with debtors, balancing company interests and client needs for mutually beneficial agreements.
- Streamlined internal processes by regularly updating collections procedures, increasing efficiency within the department.
- Developed strong relationships with customers, fostering trust and open communication during debt resolution processes.
- Met and exceeded every target I was given for the month.
- Reduced delinquency rates through effective negotiation and payment plan arrangements with clients.
Customer Service Representative
Sutherland Global Services - program Affirm - Houston, TX
10.2019 - 05.2020
- Helped customers through the application process of the Affirm loan
- Assisted customers with processing payments over the phone
- Responded to inbound emails regarding the customer’s account
- Phone numbers, and email addresses using Polaris
- Responded to customer requests for products, services, and company information.
- Walked customers through how to process returns for items bought at the store
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Set up AutoPay on their accounts and scheduled payments
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Confirmed balances to loan officers while on the phone with account holders
- Contributed to sales growth by upselling products and services based on individual customer requirements.
- De-escalation of customer calls
- Participated in team-building exercises that led to a decrease in my call hold times.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
Customer Service Representative
RUI Management Services - Melville, NY
11.2018 - 09.2019
- Made outbound calls to customers to remind them of their bills and assisted with payments over the phone to avoid service interruption and restore services
- Received Inbound calls to help customers with their payments, review their bills, and restore services if Interrupted while navigating the CSG and EINSTEIN applications
- Assisted with payment arrangement if eligible and informed customers of their cycle date and payment due date and Notated the accounts of our discussions with each customer.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Utilized customer service software to manage interactions and track customer satisfaction.
Education
GED -
GED TESTING
07.2021
Skills
- Customer support
- Escalation issues
- Problem-solving abilities
- Data entry
- Active Listening
- Excel
- Microsoft Office
- Customer Relations
- General Ledger Accounting
- Office Management
- Polaris
- CRM Software
- Avaya
References
Letter of recommendation from Memorial Hermann
Timeline
Customer Service Representative (member services)
Blue Shield of California (TTEC)
11.2022 - Current
Receptionist
Memorial Hermann Hospital
08.2021 - 11.2022
Collection Representative/agent
Convergent Outsourcing Incorporated Houston Texas
07.2020 - 09.2020
Customer Service Representative
Sutherland Global Services - program Affirm - Houston, TX
10.2019 - 05.2020
Customer Service Representative
RUI Management Services - Melville, NY
11.2018 - 09.2019
GED -
GED TESTING
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