Summary
Overview
Work History
Education
Skills
Languages
Certification
Personal Information
Software
Languages
Timeline
Hi, I’m

Wilnise Albert

Miami,FL

Summary

Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.

Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities.

Overview

16
years of professional experience
1
Certification

Work History

United Healthcare

Eligibility Representative
01.2024 - Current

Job overview

  • Enhanced client satisfaction by efficiently processing eligibility applications and addressing inquiries.
  • Reduced errors in eligibility determinations through meticulous attention to detail and rigorous quality control measures.
  • Managed high-volume caseloads while maintaining strict adherence to privacy regulations and confidentiality protocols.
  • Utilized data-driven decision-making strategies to make informed recommendations on complex cases.
  • Assisted clients with navigating complex eligibility requirements, ensuring accurate submissions.
  • Conducted comprehensive case reviews to identify potential fraud or inconsistencies in eligibility determinations.
  • Provided knowledgeable guidance to clients regarding program rules, regulations, and updates.
  • Resolved discrepancies with client applications to verify eligibility.
  • Assisted clients with accurate eligibility form, application and document completion.
  • Interviewed applicants and explained scope of different available benefits.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Scheduled appointments with applicants to gather information and explain benefits processes.
  • Improved customer service experience for applicants, providing clear explanations of eligibility requirements and addressing concerns promptly.
  • Maintained up-to-date knowledge of relevant laws, regulations, and policy changes affecting Medicaid eligibility determinations.
  • Enhanced Medicaid eligibility determinations by thoroughly analyzing applicants'' financial and personal information.
  • Resolved eligibility discrepancies by carefully reviewing regulations and collaborating with relevant parties to reach accurate determinations.
  • Collaborated with other specialists to ensure consistent interpretation of Medicaid regulations and policies.
  • Managed high caseloads efficiently, prioritizing tasks effectively and utilizing time-management skills to meet deadlines consistently.
  • Streamlined application processing for increased efficiency by implementing a well-organized case management system.
  • Coordinated closely with other social service agencies, fostering collaboration to ensure comprehensive support for clients.
  • Utilized advanced computer systems to track applicant data, generating accurate reports for internal review as needed.

Modivcare

Customer Service Representative
01.2020 - Current

Job overview

  • Answered constant flow of customer calls with minimal wait times. Managed over 70 calls per day.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Responded to customer requests for products, services, and company information.
  • Provided primary customer support to internal and external customers.
  • Updated account information to maintain customer records.
  • Developed customer service policies and procedures to meet and exceed industry service standards.
  • Participated in team meetings and training sessions to stay informed about product updates and changes.
  • Tracked customer service cases and updated service software with customer information.
  • Handled customer inquiries and suggestions courteously and professionally.
  • Cross-trained and backed up other customer service managers.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Immediately brought critical issues to customer service manager for resolution.
  • Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.

Walmart

Assistant Manager
01.2009 - 01.2019

Job overview

  • Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
  • Created employee schedules to align coverage with forecasted demands.
  • Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
  • Generated repeat business through exceptional customer service and responded to customer concerns with friendly and knowledgeable service.
  • Developed loyal and highly satisfied customer base through proactive management of team customer service strategies.
  • Strengthened merchandising and promotional strategies to drive customer engagement and boost sales.
  • Mentored team members to enhance professional development and accountability in workplace.
  • Made hiring recommendations to increase company's productivity and profitability with quality workers.
  • Reviewed sales and gross profit report to assess company efficiency.
  • Taught employees how to collaborate on daily job tasks and achieve service targets.
  • Prepared annual budgets with controls to prevent overages.
  • Spearheaded daily staff meetings to identify improvement strategies, discuss policy updates, and facilitate open communication.
  • Helped with planning schedules and delegating assignments to meet coverage and service demands
  • Reviewed sales and gross profit report to assess company efficiency

Education

Magnolia Real Estate Academy
Orlando Fl

Associate of Arts from Real Estate
01.2023

University Overview

Certifications
Level 1 Strategic Communication Certification.

3.5 GPA

  • Continuing education in nursing
  • Completed professional development in real estate services.
  • Continuing education in nursing

FVI School of Nursing And Technology
Miami, FL

BBA from Nursing
01.2018

Skills

  • Confidentiality
  • Healthcare industry
  • Client relationship building
  • Effective communication skills
  • Documentation and paperwork
  • Verbal communication
  • Microsoft office
  • Data entry
  • Interviewing
  • Appointment scheduling
  • Documentation and reporting
  • Record keeping
  • Application review
  • Telephone etiquette
  • Benefits administration

Languages

  • French

  • Creole

Certification

Sales Manager Certificate

Personal Information

Title: Customer Service

Software

Computer skills

Languages

French
Native or Bilingual
Creole
Native or Bilingual
Spanish
Professional Working

Timeline

Eligibility Representative

United Healthcare
01.2024 - Current

Customer Service Representative

Modivcare
01.2020 - Current

Assistant Manager

Walmart
01.2009 - 01.2019

Magnolia Real Estate Academy

Associate of Arts from Real Estate

FVI School of Nursing And Technology

BBA from Nursing
Wilnise Albert