RHONDALYN E. MCGRIFF
Sebastian,FL
Summary
Seeking a fulfilling career where I can utilize my education, experience and outstanding skills so I can directly contribute to the success of the organization.
Overview
14
14
years of professional experience
Work History
Inbound/Outbound - Customer Service Representative
CONVEY HEALTH SOLUTIONS
08.2015 - Current
- Consists of but not limited to communicating with customers to understand their needs
- Research and resolve customer problems
- Navigate through multiple computer applications with speed and accuracy
- Provide customers with information about additional products and services
- Receiving calls from beneficiaries enrolled in PDP or MAPD programs
- Assist beneficiaries with updating accounts
- Provide plan information and resolve issues with utilization of their plan
- Obtain new orders or reorders for products sponsored by their plan
- Resolve customer's complaints, billing issues, and perform activities such as exchanging products and refunding money to customers' accounts
- Managing accounts for 25 different insurance companies
- Manage end-to-end health insurance processes for the business clients – from eligibility and enrollment processing to service, premium billing, reconciliation OTC Administration and other quality, wellness and other related services
- Complete daily tasks of verification of prior authorizations and referrals, explanation of benefits and checking network availability of providers.
Service Manager II
WELLS FARGO BANK
01.2010 - 01.2015
- Assisted store manager in positioning the store team for success by managing the Teller line, lobby and delegating essential tasks to ensure operational integrity while creating a positive customer experience
- Observed, coached and provided feedback to the sales team to ensure consistent team performance and excellent customer satisfaction
- Hired, trained, supervised, coached and developed a highly engaged service team
- Ensured compliance with all operational regulations, sales and service processes, policies and procedures, and completion of compliance requirements
- Managed complex customer concerns and transactions.
Education
A.S. Degree - Business Administration and Management
Indian River Community College
Ft Pierce, FLSkills
- Account management
- Issue resolution
- Data Security
- Product recommendations
- Hard working
- Multitasking
- Excellent verbal and written communication
- Collection experience
- Grievances and Appeals
- Experience in health insurance/pharmacy insurance or managed care organization
- Prior authorizations
- Knowledgeable in medical terminology
- Eligibility and members benefits
- Resolving eligibility issues
- Data entry
- Experience with Microsoft Word and Excel
- Member correspondence
Timeline
Inbound/Outbound - Customer Service Representative
CONVEY HEALTH SOLUTIONS
08.2015 - Current
Service Manager II
WELLS FARGO BANK
01.2010 - 01.2015
A.S. Degree - Business Administration and Management
Indian River Community College
Similar Profiles
America MartinAmerica Martin
Inbound/outbound Customer Service Escalation, Specialist at Convey Health SolutionsInbound/outbound Customer Service Escalation, Specialist at Convey Health Solutions
Quenteria JenningsQuenteria Jennings
Customer Service & Scheduling Specialist at Convey Health SolutionsCustomer Service & Scheduling Specialist at Convey Health Solutions
Ulises MagdalenoUlises Magdaleno
Customer Service Representative at Convey Health SolutionsCustomer Service Representative at Convey Health Solutions
Shari SimpsonShari Simpson
Grievance Specialist Seasonal at Convey Health SolutionsGrievance Specialist Seasonal at Convey Health Solutions
Sara FlinnSara Flinn
Volunteer at Dodgertown Elementry SchoolVolunteer at Dodgertown Elementry School