Rodelle Destine
Homestead,FL
Summary
Customer Service bringing top-notch skills in oral and written communication, active listening and problem-solving skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude and willingness to take on added responsibilities to meet any goals given.
Overview
8
8
years of professional experience
Work History
Customer Service Representative - Remote
Express Scripts (Cigna)
01.2023 - 02.2024
- Handled customer inquiries such as EOB’s , SOBA’s , Medical Coverage, Prior Authorization and Claims.
- Answered 100-300 calls per day.
- Possess knowledge Medicare, Medicaid, and HMO, PPO, Exchange plans etc.
- Verify insurance coverage and assist with insurance claims.
- Obtain insurance eligibility and benefits, copay and/or deductible
- Assist with billing and payment processing
- Provide administrative support to the healthcare team
- Schedule patient appointments and manage the appointment calendar.
- Knowledge of medical terminology and procedure.
- Proficient in office software applications (e.g., Microsoft Office)- Answering high volume of phone calls and scheduling appointments.
- Strong organizational and multitasking abilities- Excellent communication and interpersonal skills- Attention to detail and accuracy in data entry- Ability to maintain patient confidentiality. (HIPPA)
- Handle customer service inquiries from members, providers, physicians and internal and external clients related to pharmacy benefits.
- Work to research and resolve problems in a timely manner. Assist members in understanding and maximizing the use of their pharmacy distribution program.
- Use computerized system to gather information and respond to questions. Document issues and resolutions in a common database. Escalate issues as necessary.
- Updated account information to maintain customer records.
- Processed Refills and Prescription Renewals to Doctors Office.
- Work with other operational departments to research and resolve mail order and claims issues.
- Completing corrections for the drug interaction team processing refill too soon orders and initiating phone outreach to prescriber and transfer calls to an RPH or Nurse.
- Exercise good judgement and remains knowledgeable of healthcare contracts, procedures And policies.
- Maintains teamwork and customer Service production, quality standards to assure timely , accurate, efficient and resolutions.
Human Resources Assistant/Customer Service -Remote
MMM Of Florida
03.2019 - 12.2022
- Work on Microsoft , medhok , Qnxt , claims , authorizations, referrals etc.
- Answered 80-200 calls per day.
- Verify insurance coverage and assist with insurance claims
- Obtain insurance eligibility and benefits, copay and/or deductible
- Assist with billing and payment processing
- Provide administrative support to the healthcare team - Schedule patient appointments and manage the appointment calendar.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Assisted customers with setting appointments, special order requests, and arranging merchandise pick-up.
- Educated customers about billing, payment processing and support policies and procedures.
- Delivered prompt service to prioritize customer needs.
- Maintained up-to-date knowledge of product and service changes.
- Handled over multiple calls per shift signing up new customers, retrieving customer data, presenting relevant product information and cancelling services.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Updated account information to maintain customer records.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Met customer call guidelines for service levels, handle time and productivity.
- Improved employee satisfaction by developing and implementing new HR policies and procedures.
- Enhanced onboarding experience for new hires by creating comprehensive orientation materials and training programs.
- Managed benefits administration, ensuring accurate enrollment and timely resolution of issues.
- Assisted in payroll processing to ensure timely delivery of paychecks to all employees.
- Efficiently managed personnel files, maintaining confidentiality while keeping records up-to-date and organized.
- Supported talent acquisition efforts by screening resumes, scheduling interviews, and performing reference checks for prospective candidates.
Front Desk Supervisor
Ross Dress For Less
10.2016 - 02.2018
- Monitored cash drawers in checkout stations to verify adequate cash supply.
- Responded to customer concerns with friendly and knowledgeable service and remedied issues promptly and effectively.
- Oversaw employee performance, corrected problems and increased efficiency to maintain productivity targets.
- Trained team members in successful strategies to meet operational and sales targets.
- Completed stockroom tasks by leading stock team, receiving and unpacking merchandise and placing all products out on sales floor.
Hostess
Cracker Barrell Old Country Store
10.2015 - 05.2016
- Took reservations and to-go orders by phone, answered customer questions and informed of accurate wait times.
- Assigned patrons to tables suitable for needs and restaurant section rotation.
- Supported servers, food runners and bussers with keeping dining area ready for every guest.
- Planned and executed multiple guest parties by organizing menus, spaces and special requests.
Education
High School Diploma - Criminal Justice
Lawrence Academy
Doral, FL06.2016
Skills
- Issue and Complaint resolutions
- Upbeat and Positive Personality
- Calm and Professional Under Pressure
- Efficient and Detail-Oriented
- Data Entry and Maintenance
- Inbound and Outbound Calling
- Active Listening
- Critical thinking
- Team Leadership
- Type Software Proficiency
- Dependable and Responsible
- Scheduling
- Administrative Support
- Computer Proficiency
Languages
French
Native or Bilingual
Creole
Native or Bilingual
Timeline
Customer Service Representative - Remote
Express Scripts (Cigna)
01.2023 - 02.2024
Human Resources Assistant/Customer Service -Remote
MMM Of Florida
03.2019 - 12.2022
Front Desk Supervisor
Ross Dress For Less
10.2016 - 02.2018
Hostess
Cracker Barrell Old Country Store
10.2015 - 05.2016
High School Diploma - Criminal Justice
Lawrence Academy
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