Secleary Joselin Tavares
Lemoore,Ca.
Summary
Dedicated and detail-oriented Enrollment Services Representative with 8 years of experience enrolling clients into medical health plans, verifying eligibility, and providing exceptional customer service. Skilled in navigating healthcare enrollment systems, explaining plan benefits, maintaining compliance with healthcare regulations, and assisting clients throughout the enrollment process. Proven ability to handle high-volume workloads while ensuring accuracy, professionalism, and client satisfaction.
Overview
8
8
years of professional experience
Work History
Enrollment Services Representative
Maximus
09.2018 - Current
- Assist clients with enrollment into medical health insurance plans.
- Verify eligibility and ensure all enrollment requirements are met.
- Educate members on available healthcare coverage options and benefits.
- Review applications for completeness and accuracy.
- Maintain detailed and confidential client records in compliance with HIPAA regulations.
- Resolve enrollment issues and assist clients with coverage questions.
- Coordinate with healthcare providers, insurance carriers, and internal departments to ensure successful enrollments.
- Process enrollment changes, renewals, and updates efficiently.
- Meet productivity, quality, and customer satisfaction goals.
Enrollment Specialist / Member Services Representative
- Assisted members with healthcare plan information and enrollment procedures.
- Conducted eligibility screenings and benefit verification.
- Provided support for application completion and documentation collection.
- Maintained accurate records and updated member information.
- Responded to inquiries regarding coverage, benefits, and enrollment status.
Education
Hanford High School
Hanford, CAHigh School Diploma -
Hanford High school
Hanford, CaSkills
- Health Plan Enrollment
- Eligibility Verification
- Member Services
- Healthcare Regulations Compliance
- Customer Service Excellence
- Data Entry & Documentation
- Problem Resolution
- Insurance Plan Education
- HIPAA Compliance
- CRM & Enrollment Systems
- Communication Skills
- Case Management
- Administrative Support
- Enrollment Management Systems
- Customer Relationship Management Software
- Data Entry & Record Management
- Strong attention to detail
- Excellent customer service skills
- Ability to handle sensitive information confidentially
- Effective communication and interpersonal skills
- Strong organizational and multitasking abilities
- Ability to work independently and as part of a team
- Benefit education
- Problem resolution
- Attention to detail
- Time management
- Team collaboration
- Strong organization
- Critical thinking
Languages
- English
- Spanish
Timeline
Enrollment Services Representative
Maximus
09.2018 - Current
Enrollment Specialist / Member Services Representative
Hanford High School
High School Diploma -
Hanford High school