Dedicated professional with extensive experience in customer service and problem-solving, honed at CVS Caremark. Excelled in deescalation proficiency and HIPAA compliance, effectively handling high call volumes and complex issues. Demonstrated mastery in utilizing technology to enhance customer satisfaction and operational efficiency. Proven track record in improving customer experience through empathetic engagement and skilled communication.
Overview
4
4
years of professional experience
Work History
Customer Service Representatives- Dental
CVS Caremark
Remote (Washington DC)
10.2023 - Current
Answer questions & resolve issues from Members, Providers & Plan Sponsors Via phone & electronic communication.
Document & track contacts with Members & Providers.
Build & establish rapport with Members by demonstrating empathy & understanding needs to provide best information for best health.
Provide Members with benefit plan details, additional plan benefits & Member self-service toll.
Process claim referrals, new claim handoffs, Member & Provider complaints & grievances and appeals via target system.
Educate Providers on the self-service options & assist Providers with credentialing issues.
Sr Customer Service Representative- HCN Ops
Aetna Resources, LLC / CVS Caremark
Remote (Hartford, CT & DC)
02.2021 - 10.2023
Professionally answered high call volume.
Efficiently navigated through multiple computer software systems in order to provide customers with most relevant & accurate enrollment & benefit plan information.
Mastered effective listening in order to identify the callers concerns, issues & complaints.
Effectively deescalated customer concerns & complaints in a manner that positively represented company guidelines with appropriate tone & language.
Performed efficient operation of the AVA system to successfully direct callers to appropriate company departments respective to specific needs & requests.
Directed & facilitated technical support for Members & Providers in the Navigator self service online system.
Facilitated special projects as requested by department manager.
Customer Service Representative (CSR), Customer Service Representatives at Senture/FemaCustomer Service Representative (CSR), Customer Service Representatives at Senture/Fema