Summary
Overview
Work History
Education
Skills
Timeline
Generic

Roxanne Pena

Camarillo,CA

Summary

Enthusiastic representative that is eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of quality and attention to detail and training in Customer Service. Motivated to learn, grow and excel in daily activities.

Overview

17
17
years of professional experience

Work History

Agent Specialist

Pathian - LLC
03.2020 - 01.2024
  • Provide excellent customer service.
  • Develop and maintain positive customer relations (i.e., ensure customer requests and inquiries are handled in appropriate and timely manner).
  • Responsible for processing agent/agency's appointment and contracting with in company.
  • Respond to inquiries involving commissions, legislation, product information and policies and procedures for Inshore via telephone or written communication.
  • Assigned incoming emails to appropriate administrator.
  • Processed broker of record changes, split commissions as well as book of business transfers.
  • Updated agent/agency's license and E&O to ensure there is no disruption in commission payments on a monthly basis.
  • Researched commission aged fixable and aged payables.
  • Updated broker polices and procedure's as needed.
  • Document inquiry outcomes for tracking and analysis purposes.
  • Processed production which included, enrollments, terminations, provided invoices, renewals, SOB, EOC, census and forms.
  • Assisted with enrolling new business as needed.
  • Audited new business
  • Assisted with entering new test groups and individual plans
  • Responsible for any Management assigned special projects.
  • Met or exceeds all performance requirements and goals.

Agency Rep III, Medicare Sales OPS and SRV

WellPoint, Anthem Blue Cross
08.2011 - 03.2020
  • Respond to customer questions regarding insurance benefits, provider contracts, eligibility and claims.
  • Provide training and mentoring to newly hired employees.
  • Develop and maintain positive customer relations (i.e., ensure customer request and inquiries are handled in appropriate and timely manner).
  • Document inquiry outcomes for tracking and analysis purposes.
  • Responsible for providing advanced customer service support to brokers selling Anthem products via telephone or written communication.
  • I have worked on special projects for brokers, broker representatives, or other MBUs and create new reports to meet client needs.
  • Responds to inquiries involving commissions, legislation, product information and policies and procedures for Senior Broker services.
  • Managed over 70 to 80 phone calls per day.
  • Averaged 15 to 20 pieces of correspondence to be processed per day.
  • Coordinates mailings and fulfillment requests. Provides reports to brokers.
  • May perform simple Enrollment and Billing maintenance transactions.
  • Perform Medicare and Medicaid status checks.
  • Mets or exceeds all performance requirements and goals on a regular basis.

Membership Representative III, Membership

WellPoint, Anthem Blue Cross
02.2010 - 05.2011
  • Analyzes and process Medicare Advantage and Part D applications in accordance with Center for Medicare and Medicaid Services (CMS) guidelines.
  • Provided support in implementation of new software system for coordination of benefits (COB).
  • Responsible for handling special projects assigned by Manager.
  • Solely charged with the responsibility of completing coordination of benefit suppression research reporting.
  • Additional responsibilities include processing of dis-enrollments, plan changes, address changes and COB verification letters.
  • Met or exceeded all performance requirements and performance goals on regular basis.

Customer Care Representative Sr.

WellPoint, Anthem Blue Cross
12.2006 - 02.2010
  • Responsible for processing enrollment and billing for small groups.
  • Proficient in all aspects of customer service.
  • Streamlined call response times for improved customer experience through effective communication techniques.
  • Logged call information and solutions provided into internal database.
  • Trained new employees on best practices and customer care procedures to eliminate inefficiencies.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Followed up with customers about resolved issues to maintain high standards of customer service.
  • Responsible for any Management assigned special projects.

Education

High School Diploma -

Channel Islands High School
Oxnard, CA
06.1993

Skills

  • Sales and service-oriented
  • Good communication skills
  • Telephone etiquette
  • Conflict resolution
  • Excellent written and oral communication
  • Data management
  • Multitasking Abilities
  • Professional telephone demeanor
  • Complaint resolution
  • MS Office proficiency
  • Remote Office Availability
  • Self-Directed
  • Calm Under Pressure

Timeline

Agent Specialist

Pathian - LLC
03.2020 - 01.2024

Agency Rep III, Medicare Sales OPS and SRV

WellPoint, Anthem Blue Cross
08.2011 - 03.2020

Membership Representative III, Membership

WellPoint, Anthem Blue Cross
02.2010 - 05.2011

Customer Care Representative Sr.

WellPoint, Anthem Blue Cross
12.2006 - 02.2010

High School Diploma -

Channel Islands High School

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