Twila Weaver

High Profile Employer Group, MAOM Mountain West & NST

• Mentor and coach Customer Service Advocates, delivering Feedback from call evaluations and closed loops to improve performance, compliance, and NPS/UES scores.
• Lead training on customer service skills, grievance and appeal policies, and system processes, while supporting team operations through tools like Maestro, Knowledge Central, and Medicare.gov.
• Manage queue, team schedules, and adherence using Pulse and Supervisor Webstation, ensuring optimal coverage and service levels.
• Supported representatives in navigating difficult interactions with customers, offering guidance on appropriate de-escalation techniques when needed.
• Foster a positive team culture through engagement activities and implement process improvements to enhance efficiency and service delivery.

Partner Employee M&R Core Class | MA/PDP New Hire OJT & Transition Team

• Delivered onboarding and on-the-job training for new Customer Service Advocates, using different teaching methods to support diverse learning styles and ensure readiness for live calls.
• Facilitated call shadowing sessions and monitored team chats to guide new hires in real-time, helping them navigate tools like Maestro, Knowledge Central, Rally, and MARX
• Evaluated performance using Qualtrics, Qfiniti, and Nexida: provided targeted coaching and feedback to address skill gaps and improve service quality.
• Reported attendance, behavioral observations, and coaching outcomes to Partner Support Staff using PMC and adherence tracking tools.

Advocate4Me | Employer Retiree Groups | IBM Retiree Group

• Resolved member inquiries concerning benefits, eligibility, claims, and plan changes, while consistently delivering first-call resolution and high-quality service.
• Educated members on medical, drug, dental, vision, and wellness benefits, and assisted with provider appointments and pharmacy management.
• Identified urgent needs and connected members with community resources
• Utilized systems such as Maestro, Grif, and Knowledge Central to manage member data, while supporting tam collaboration.

Medicare & Retirement - Government Operations

• Assisted with Inbound calls related to enrollment, plan changes, and reinstatements, focusing on resolving issues and retaining members.
• Educated members on their plan benefits and guided them through plan comparisons to ensure the best fit for their needs.
• Used active listening and problem-solving skills to address concerns, improve satisfaction, and prevent disenrollment.

• SME for CalPERS team, providing guidance and resources to resolve complex member and pharmacy issues across multiple lines of business.
• Mentored team members via chat support, providing real-time assistance and sharing tools, SharePoint, and job aides.
• Researched and resolved escalated issues, delivered callbacks to members and pharmacies to ensure satisfaction and prevent further escalation.
• Utilized RxClaims to manage holding plans, perform overrides, and make temporary account updates.

CalPERS - TennCare - Sonj - District Council 37 & UMR - Carve In M&R

• Delivered exceptional support to members, physician offices, and internal teams, addressing inquiries related to benefits, claims, billing, Medicare Part D, and OptumRx mail services.
• Acted as a liaison for retail pharmacies, resolving claim rejections, medication coverage issues, and member processing concerns.
• Utilized RxClaims to perform account updates, process overrides, and ensure accurate and timely resolution of member issues.
• Supported high-touch clients and specialized lines of business, contributing to service level achievements and operational efficiency.

• Provided customer service and sales support for security products, processing high volumes of orders and quote requests from U.S. Government and international clients.
• Performed administrative duties including receptionist backup, meeting coordination, badge creation, and mail handling to support daily operations.
• Resolved customer issues efficiently while identifying and implementing process improvements to enhance service quality and workflow.
• Utilized CRM systems, Microsoft Office Suite, and order management tools to streamline workflows and resolve customer issues effectively.