Tisha Jimenez
Winter Haven,FL
Summary
Adaptable professional with over 8 years of experience in customer service and administrative support. Skilled in handling escalations, appeals, and authorizations with accuracy and empathy. Strong communicator recognized for resolving issues effectively, ensuring compliance, and maintaining positive client and team relationships. Quick learner with proven ability to thrive in fast-paced environments. Organized and dependable while successful at managing multiple priorities with a positive attitude.
Overview
9
9
years of professional experience
Work History
Licensed Insurance Agent
The Results Companies
01.2018 - 01.2022
- Educated clients on Medicare Advantage Plans.
- Assessed client needs and matched them to appropriate plans that covered required medications and doctors.
- Built trust and promoted client retention through excellent service and follow-up.
- Stayed up-to-date on plan changes, policies, and compliance requirements.
- Guided clients through Open Enrollment and Special Enrollment Periods (SEPs).
- Verified client data, calculated premiums, and processed applications with accuracy.
- Resolved client inquiries and disputes by clearly explaining benefits and coverage details.
- Managed a high volume of inbound calls while consistently maintaining a high level of customer satisfaction.
Account Supervisor
The Results Companies
01.2017 - 01.2018
- Supervised client accounts, ensuring timely resolution of issues and proactive support to meet client needs.
- Oversaw escalations, grievances, and appeals, guiding cases from initial inquiry to resolution while maintaining compliance with policies.
- Acted as primary liaison between clients and internal teams, streamlining communication and reducing response times.
- De-escalated challenging situations, preserving client relationships and preventing potential disputes.
- Coordinated with healthcare providers to collect and submit necessary authorization forms, ensuring accurate and timely processing.
Telemarketer
Encore Petroleum
01.2016 - 01.2017
- Engaged with customers to understand their oil product needs and provided tailored solutions.
- Built and maintained strong client relationships, ensuring customer satisfaction and repeat business.
- Assisted clients with product selection, pricing inquiries, and logistical coordination.
- Maintained accurate records, managed transactions, and ensured precision in reporting and billing.
Front Desk Manager
Slope Fitness
01.2013 - 01.2015
- Greeted clients and visitors, providing excellent customer service and creating a welcoming environment.
- Oversaw daycare operations, ensuring safety, cleanliness, and proper supervision of children.
- Conducted tours for potential clients, highlighting facilities and answering questions about programs and services.
- Assisted clients with completing contracts and clarified any questions or concerns regarding policies.
- Maintained financial accuracy by handling cash at closing and ensuring all funds were securely stored.
- Ensured the facility was clean, organized, and well-maintained at all times.
Education
High School Diploma -
Dickinson High School
Jersey City01.2011
Skills
- Customer Service & Escalation Management
- Communication & Collaboration
- Policy & Compliance Adherence
- Documentation & Data Accuracy
- Problem Solving & Conflict Resolution
- Appeals Processing
- Insurance sales expertise
- Client account management
- Client retention
- New agent training
- Licensed insurance agent
- Billing inquiries
- HIPAA compliance
- Data entry
Timeline
Licensed Insurance Agent
The Results Companies
01.2018 - 01.2022
Account Supervisor
The Results Companies
01.2017 - 01.2018
Telemarketer
Encore Petroleum
01.2016 - 01.2017
Front Desk Manager
Slope Fitness
01.2013 - 01.2015
High School Diploma -
Dickinson High School