Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Tanuja Singha

Carrolton,Texas

Summary

A hard-working Customer Care Specialist with 14+ years of experience in a Customer Service/Call Center environment Extensive work experience within the service industry with absolute customer orientation. Experience working with Call Management Systems and Record Filling systems, particularly Dish Promo, Ice pack, Oracle, MS SharePoint, CTI, Facets, Kareo, Digichart, Work force Management, Tech Portal, Aspect, Max EB, E-Paces, Pipkins, Maestro, IEX, intradiem, Macro express pro, Genesys etc. Extensive exposure to the fast-paced work environment at call centers Strong experience maintaining organized files and working with vendors to maintain relationships. Ability to multi-task in a time-sensitive environment Experienced and equipped to work from home, hybrid or on site Self-motivated and require minimal supervision.

Focused customer service professional dedicated to meeting and exceeding customer expectations by delivering industry-leading support. Skilled in handling inbound and outbound calls, online requests and emails with good problem-solving, multitasking and research abilities. Background in the field roles with high-volume customer demands.

Customer service professional with proven ability to enhance customer satisfaction and streamline service processes. Known for collaborative teamwork and achieving consistent results in dynamic environments. Effective communicator with strong analytical and problem-solving skills.

Overview

18
18
years of professional experience

Work History

Customer Care Specialist

United HealthCare
09.2017 - Current
  • Company Overview: Medicare & Retirement Certified
  • Trained in NICE and COSMOS platforms
  • Assist Member with benefits inquiry, Claims inquiry, billing
  • Educating members on plan details and benefits
  • Care coordination for member including scheduling provider office visits and house calls
  • Documented and tracked member interactions in CRM system, ensuring accurate and up to date records for efficient follow ups
  • Worked with high profile member groups such as CalPERS (California) and UAW trust (Nationwide)
  • Acted as Liaison between members and other departments ensuring one call resolution
  • De-escalated calls for unsatisfied members providing options and resolutions
  • Training to keep abreast with new policy changes
  • Ensuring high level of communications with members to resolve all issues while being compliant with all business policies
  • Taking LEP reporting and attestations
  • Filing verbal grievances, Quality of Care grievances, MIOD (Member Initiated Organization Determinations) and appeals for the member
  • Reporting Fraud, waste and abuse
  • Complying with all HIPAA laws
  • Identifying Social Detriments for the member and connecting them with local community resources
  • Assisting with online registration and navigation of the website and mobile app
  • Navigating group retiree DTC sales data
  • Tracking call trends and reporting
  • Data entry for Member PHI (Protected Health information)
  • Train New Hires in a shadow program, assist team members via chat, email and video calls
  • Consistently met or exceeded performance metrics related to customer satisfaction, issue resolution and case volume
  • Using tools such as Maestro, Genesys, SharePoint, IEX, knowledge central, Excel, word, Power point, Microsoft office 365, Sparq, GPS, CMS enterprise portal, Marx, RX claims, Performance Management tool, My Metrics, rally, PAS, Advocate central, Team, outlook, one note, Intradiem, Macro express pro, Copera etc
  • Medicare & Retirement Certified

Customer Service Representative

AppleOne New York
02.2017 - 07.2017
  • Company Overview: Assignment: New York Medicaid Choice (Maximus, New York)
  • Assist consumers in enrollment/disenrollment/transfer into a plan
  • Documenting complaints and grievances against a plan
  • Responding to customer inquiries received by phone regarding their Medicaid case
  • Documenting customer interactions, transactions, details of inquiries, complaints, comments and action plans
  • Follow standard operating procedures to ensure consistency and accuracy
  • Refer unresolved consumer grievances to the designated departments for further investigations
  • Communicate with supervisors regarding any potential needs or concerns
  • Send out Exemption/Exclusion forms where necessary after determining the category
  • Send out appropriate forms to the consumer such as the good cause packet, consent forms etc
  • Conduct conference calls with the assigned plan and the consumers to resolve issues and provide consumer with options
  • Create and assign tasks to the Special Units Project to research and review cases
  • Train new hires in a shadow program
  • Perform other duties as assigned by the management
  • Assignment: New York Medicaid Choice (Maximus, New York)

Front Desk Receptionist

Innovative Healthcare Physicians (OB/GYN)
09.2016 - 12.2016
  • Assisting patients with checking in and out of the office
  • Booking appointments on the phone and via emails (zoc doc and patient pop)
  • Checking insurance eligibility and updating insurance information
  • Maintaining patient records up to date
  • Registering new patients
  • Scheduling in-hospital and outpatient procedures
  • Filling out Prior Authorization paperwork for insurance
  • Keeping in sync with the doctors’ schedules
  • Faxing/emailing and receiving reports, prescriptions to the patients, pharmacies, other doctor offices
  • Filling out paperwork for women’s contraceptive methods
  • Calling/faxing in prescriptions to pharmacies on file
  • Answering phone calls from patients, representatives, hospitals, other doctor’s offices
  • Assisting patients and pharmacies in clarifying medicines, dosage and any non-medical inquiries or directing them to the medical staff as required
  • Systems used Kareo, Digichart, Nextiva fax, Care tracker

Member Services Associate

Fidelis Care Health insurance, NY
11.2014 - 03.2016
  • Assisted members in application, recertification process and provided leads for Child Health Plus (CHP) and Medicaid
  • Assisted members in searching for in-network specialists, providers, Primary Care Physicians, hospitals and other medical Facilities
  • Educated members on Benefits
  • Sent out ID cards, provider directories, verification letters and HIPPA letters and any other requested information via mail/fax
  • Checked on Prior Authorizations for providers for procedures and pharmacy
  • Assisted in billing resolutions and medical claims
  • Answered premium inquiries for CHP members
  • Familiar with and practiced HIPPA laws
  • Provided guidance and assistance in regard to the affordable health care act
  • Completed Health Risk Assessments (HRA)
  • Primary system used was Facets

Customer Care Specialist

Dish Network
09.2009 - 08.2014
  • Delivered world class customer service and build customer satisfaction and loyalty
  • Provided effective and timely resolution of a range of customer inquiries
  • Strived for one-call resolution of customer issues
  • Completed ongoing training to stay abreast of product, service and policy changes
  • Demonstrated best judgment in the disbursement of adjustments and credits
  • Increased the customer experience by providing information on new products, rate plans, and services through up selling opportunities
  • Helped customers choose the best programming and equipment based on their entertainment needs and budget
  • Explained billing and resolved payments related issues over the phone
  • Handled customer retention by selling the value of the company and offering rebuttals against the competition
  • Offered step by step technical assistance to the customer in operating, fixing and programming the receivers and remotes
  • Opened new customer accounts
  • Facilitated and expedited the escalation of customer service issues
  • Utilized multiple call center support applications to efficiently assist customers and agents
  • Systems used Dish promo, Icepack

Recruiter/ Office Clerk

Aristontek
01.2012 - 09.2012
  • Managed client’s records into archives for permanent storage
  • Maintained and organized files
  • Helped clients with visa applications and status
  • Helped clients with building resumes to enhance skills and highlight strengths
  • Conducted the initial round of interviews for potential clients

Restaurant Manager

Kaieteur Bar and Restaurant
04.2007 - 01.2009
  • Welcomed customers and enhance their experience by creating a friendly and family-oriented atmosphere and adhering to their needs
  • Orchestrated recipe/menu development based on guest trends/preferences and seasonal considerations; sourced vendors and negotiate inventory costs
  • Demonstrated skills accommodating private parties featuring corporate heads and celebrities; credited with high degree of diplomacy resolving problems without sacrificing customer relations
  • Maintained vendor relationships and interacted with vendors as needed
  • Hired and Trained restaurant sales staff in operating, marketing and products
  • Worked with Microsoft PowerPoint, Excel and Word daily

Education

BMCC - Liberal Arts

BMCC

El Centro - Paralegal

El Centro

Skills

  • Windows 98
  • Windows ME
  • Windows 2000
  • Windows XP
  • Windows VISTA
  • Windows 10
  • Windows 11
  • DOS
  • MS Office
  • Word
  • Excel
  • PowerPoint
  • Microsoft Outlook
  • OneNote
  • Internet Concepts
  • Customer service excellence
  • Quality assurance
  • [Product or service] support
  • Payment processing
  • Billing coordination
  • Custom order management
  • Email correspondence
  • Call logging
  • Email communication
  • Active listening
  • Issue follow up
  • Claims monitoring
  • Brand representation
  • Time management
  • Security verification
  • Technical troubleshooting
  • Appointment scheduling
  • Problem resolution
  • Point-of-sale system
  • Task prioritization
  • Phone etiquette
  • Punctuality and reliability
  • CRM software
  • Cataloging
  • Customer relationship management
  • Data entry
  • Conflict mediation
  • Senior leadership support
  • Database research
  • Decision trees
  • Inbound customer service
  • Customer relations
  • Documentation and reporting
  • Customer service
  • Empathy and patience
  • Call handling
  • Product education
  • Verbal and written communication
  • Product knowledge
  • Contract negotiation expertise
  • Stress management
  • First call resolution
  • Call center experience
  • Multitasking and organization
  • Complaint handling
  • Order processing
  • Relationship building
  • Decision-making
  • Issue escalation
  • Project management
  • Adaptability and flexibility
  • Cultural awareness
  • Effective Upselling Strategies

Languages

English
Native or Bilingual
Hindi
Native or Bilingual
Bengali
Native or Bilingual
Urdu
Professional Working

Timeline

Customer Care Specialist

United HealthCare
09.2017 - Current

Customer Service Representative

AppleOne New York
02.2017 - 07.2017

Front Desk Receptionist

Innovative Healthcare Physicians (OB/GYN)
09.2016 - 12.2016

Member Services Associate

Fidelis Care Health insurance, NY
11.2014 - 03.2016

Recruiter/ Office Clerk

Aristontek
01.2012 - 09.2012

Customer Care Specialist

Dish Network
09.2009 - 08.2014

Restaurant Manager

Kaieteur Bar and Restaurant
04.2007 - 01.2009

El Centro - Paralegal

El Centro

BMCC - Liberal Arts

BMCC

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