Raigan Downer
Ellicott City,MD
Summary
Dynamic administrative professional with extensive experience at CareFirst BlueCross BlueShield, excelling in customer service and effective communication. Proven ability to manage complex logistics and enhance team efficiency. Proficient in Microsoft Office and adept at building strong client relationships, ensuring seamless operations and high satisfaction levels.
Overview
11
11
years of professional experience
Work History
Administrative Assistant External Audit Team
CareFirst BlueCross BlueShield
05.2023 - 06.2025
- Scheduled and coordinated audit related meetings, both in person and virtually
- Managed logistics like room reservations, access arrangements, and setting up technology for virtual audits
- Prepared and organized audit documentation packets for internal teams, audit leadership and external auditors
- Maintained calendars for the Director of the EAC team
- Documented and kept logs for all Par Plans completed
- Completed redactions for documents containing HIPPA / complex information dealing with Care First
- Managed all the files in the share drive for the EAC team
- Worked directly with other admins across the division to ensure leadership had the correct supplies to be successful
- Worked well as a Team player to ensure things ran smoothly
Customer Service Specialist
CareFirst BlueCross BlueShield
06.2021 - 05.2023
- Handle inbound inquires from members
- Product information, benefits, eligibility, billing, and claims processing
- Calculated deductibles and maximums to manage overpayments/underpayments
- Accurately documented all client interactions per department protocol
- Updated customer records and account information using internal systems
- Assisted members in policy updates and payments toward policies
Wellness Specialist
CareFirst BlueCross BlueShield
04.2019 - 03.2021
- Created itineraries
- Deigned, coordinated, and promoted target wellness programs both virtually and in-person
- Helped manage wellness budgets to maximize engagement and participation
- Tracked key performance metrics and data to evaluate program effectiveness
- Partnered with internal and external departments to deliver integrated wellness offerings
- Crafted wellness communications, like newsletters, flyers and promotional materials to boost participation
Large Group Sales, Sales Assistant
CareFirst BlueCross BlueShield
03.2017 - 04.2019
- Actively answering calls
- Transferring calls
- Working directly under three Account Managers, five Account Executives, supervisors, and directors in the Large Group sales Department
- Working with Excel, SearchLight, Outlook, the CareFirst data base, SharePoint, Microsoft Word, Oracle Financial System, and OneStop
- Ordering items for accounts
- Shipping out orders for accounts
- Collecting data for BICC reports
- Scheduling meetings and calendar Access
- Inputting Meetings in the Wellness Fair database
- Updating internal audit documents
- Updating account Contacts
- Booking services for Open enrollment meetings, and Wellness Fairs
- Schedule A and C 5500 forms
- Gathering materials for account meetings
- Binding information into booklets for accounts
- Booking travels
- Processing OneStops
- Processing Check Request, and expense reports
Customer Service Representative
Whaley Insurance Agency
01.2014 - 12.2016
- Company Overview: (call center)
- Actively listen to each customer with patience and courtesy.
- Use troubleshooting and problem-solving skills to come up with solutions.
- Use great communication skills to resolve customer's device, billing and insurance concerns.
- Build customer relationships-earn their loyalty and trust by being polite and helpful.
- Provide excellent customer service by responding promptly to all inbound customer calls regarding personal lines policies, limited by geographic area and line.
- Build rapport with each customer. Listen to customers' requests and inquiries. Work to retain policyholders who inquire about canceling through open listening, policy review of customer issues, and escalation to the appropriate team if necessary.
- Process policyholder transactions accurately and within Customer Response Center established time standards.
- Interpret policy contracts to insured based on knowledge of Personal Insurance auto products. Identify, understand and interpret customer needs to implement resolutions and makes recommendations for coverage enhancements. For features or products outside of auto, escalate the policyholder to the appropriate team.
- Understand aspects of billing systems as it pertains to policy coverage. Identify and communicate transactions and impact to policy premium. Evaluate and makes decisions regarding exceptions to payment plan and fees. Make alternate payment arrangements with customers and interact with billing system to reflect arrangements. Place policy in follow-up and ensure adherence to arrangements specified.
- Manage and utilize time effectively to ensure department meets required service levels for improved customer satisfaction results.
- Utilize on-line reference materials to provide confident, accurate, and efficient information. Develops and maintain product, procedural and technical systems knowledge.
- Utilize technical systems, effectively and efficiently, including desktop, call center specific phone systems and the internet.
Education
Bachelor's Degree - Family Consumer Sciences
Morgan State University
5 2015
Skills
- Operating systems and networking
- Microsoft Office suite
- Customer service and relations
- Effective communication skills
- Call center operations
- Complaint resolution
- Telephone etiquette
- Customer relationship management
References
Available upon request
Timeline
Administrative Assistant External Audit Team
CareFirst BlueCross BlueShield
05.2023 - 06.2025
Customer Service Specialist
CareFirst BlueCross BlueShield
06.2021 - 05.2023
Wellness Specialist
CareFirst BlueCross BlueShield
04.2019 - 03.2021
Large Group Sales, Sales Assistant
CareFirst BlueCross BlueShield
03.2017 - 04.2019
Customer Service Representative
Whaley Insurance Agency
01.2014 - 12.2016
Bachelor's Degree - Family Consumer Sciences
Morgan State University