Sophia Caughman
Columbia,SC
Summary
Dynamic Eligibility Specialist , skilled in policy interpretation and effective communication. Proven track record in reducing errors in eligibility determinations and enhancing application processing efficiency. Adept at navigating Medicaid eligibility procedures while delivering exceptional customer service and problem-solving support to applicants. Committed to compliance and continuous improvement.
Overview
24
24
years of professional experience
Work History
Eligibility Specialist
TEKsystems
Columbia, SC
03.2024 - Current
- Conducted eligibility assessments for applicants based on established guidelines.
- Assisted in processing applications and verifying documentation accuracy.
- Collaborated with team members to streamline application review processes.
- Provided support in responding to applicant inquiries regarding eligibility criteria.
- Learned eligibility determination tools and systems for efficient application processing.
- Developed understanding of compliance regulations related to eligibility requirements.
- Participated in training sessions to enhance knowledge of program guidelines and procedures.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
Owner
Sophias Choice Makeup/Hair Studio
Columbia, SC
11.2016 - Current
- Oversaw daily operations, ensuring adherence to quality standards and service excellence.
- Established strong vendor relationships, negotiating contracts that resulted in cost savings for the business.
- Provide hair services for clients, offer product recommendations
- Educate customers on proper hair care techniques
Customer Service Representative
Conduent
Columbia, SC
02.2018 - 03.2024
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Assisted in processing applications from inbound callers.
- Assisted in processing account updates, routing callers to accurate departments
- Maintained accurate records of customer interactions in CRM systems.
- Provided feedback to management on recurring issues to improve service processes.
- Adapted quickly to changing applicant qualifications, information and service protocols.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
Technical Support Coordinator
Verizon Wireless
Columbia, SC
10.2001 - 09.2015
- Coordinated technical support operations to resolve client issues efficiently
- Collaborated with supervisors to escalate and address customer inquiries or technical issues.
- Recorded and maintained relevant notes for each client and work order.
- Walked individuals through basic troubleshooting tasks.
- Explained technical information in clear terms to promote better understanding for non-technical users.
- Fielded inbound phone calls to deliver support and remotely resolve service issues.
- Also provided customer service
- Managed high levels of call flow and responded to technical support needs.
Education
Licensed Instructor - Cosmetology
Master of Teaching in Instructor Cosmetology
Columbia SC03-2017
Associate of Arts - Associate of Arts Business Administration
American Intercontinental University
Chandler05-2006
Skills
- Data entry
- Effective communication skills
- Microsoft office
- Telephone etiquette
- Documentation and reporting
- Documentation and paperwork
- Policy interpretation
- Medicaid
- Eligibility procedures
- Eligibility determination
- Problem-solving
- Application support
- Customer service
- Disability awareness
Timeline
Eligibility Specialist
TEKsystems
03.2024 - Current
Customer Service Representative
Conduent
02.2018 - 03.2024
Owner
Sophias Choice Makeup/Hair Studio
11.2016 - Current
Technical Support Coordinator
Verizon Wireless
10.2001 - 09.2015
Licensed Instructor - Cosmetology
Master of Teaching in Instructor Cosmetology
Associate of Arts - Associate of Arts Business Administration
American Intercontinental University