Takeiya A. Wells
Tucson
Summary
Dedicated senior professional with several years of experience in providing superb customer service. Expert in establishing rapport by listening to customers and understanding specific needs. Manage consistent one-call resolution to offer prompt and streamlined service.
Overview
19
19
years of professional experience
Work History
Senior Customer Service Representative
OptumRx
01.2015 - Current
- Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers
- Handle escalated calls, resolving more complex customer issues in a one and done manner
- Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs))
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
- Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
- Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
- Assist customers in navigating UnitedHealth Group websites and encourage and reassure them to become self-sufficient
- Make outbound calls to customers on prescription orders and payment issues
- Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
- Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
- Provide education and status on previously submitted pre-authorizations or pre-determination requests
- Meet the performance goals established for the position in the areas of: efficiency, call quality, provider satisfaction, first call resolution and attendance
Direct Service Professional
AIRES
01.2009 - 01.2015
- Collects and enters data and information necessary to meet management information and continuous quality improvement
- Maintains files at group home including logs, resident finances, resident files, and other documentation required by AIRES and / or DDD(Department of Developmental Disabilities)
- Prepares and submits reports in accordance with deadlines such as but not limited to Consumer Monthly Progress Reports and quarterly Program Evaluation forms
- Completes all DDD required trainings and continues to improve skills through trainings required and / or provided by AIRES
- Provides direct care to ensure that residents attend to medical appointments, programs and activities and receive daily care as intended, Prepares menus and ensures dietary needs are met
- Administer medications and records such in compliance with AIRES’s policies and procedures which conform to DDD guidelines
- Develops and maintains a positive relationship with each resident
Program Service Evaluator
DEPARTMENT OF ECONOMIC SECURITY
01.2008 - 01.2009
- Responsible for completing initial eligibility determinations and annual reviews for Medicare Cost Sharing programs
- Interview customers by phone and in person
- Gather financial information; review applications and correspondence; obtaining verifications
- Data entry of eligibility information into the eligibility system
- Responsible for meeting established productivity, quality and timeliness standards
- Knowledge of Federal rules and regulations for Family Assistance and Medical Assistance
Customer Service Representative
SEARS
01.2007 - 01.2009
- Assist in sales and technical support about products, services, and merchandise
- Assist with placement of orders, refunds, or exchanges
- Resolves problems by clarifying issues; researching and exploring answers and alternative solutions; implementing solutions; escalating unresolved problems
- Maintains call center database by entering information
Education
Medical Assistant -
Pima Medical Institute
Bachelor of Arts - Business Management
International Institute of the Americas
Associate of Arts - Criminal Justice Administration
International Institute of the Americas
Skills
- Excellent oral and written communication
- Organizational prioritizing
- Multi-tasking
- Attention to detail
- Ability to learn
- Ability to interpret and apply program rules
- Ability to apply policies and procedures
- Quick learning of new procedures
- Time management
- Independence in work
- Professional relationship management
- Excel
- Word
- Outlook
- Access databases
Timeline
Senior Customer Service Representative
OptumRx
01.2015 - Current
Direct Service Professional
AIRES
01.2009 - 01.2015
Program Service Evaluator
DEPARTMENT OF ECONOMIC SECURITY
01.2008 - 01.2009
Customer Service Representative
SEARS
01.2007 - 01.2009
Medical Assistant -
Pima Medical Institute
Bachelor of Arts - Business Management
International Institute of the Americas
Associate of Arts - Criminal Justice Administration
International Institute of the Americas