Yaireth Garcia
Laredo,TX
Summary
Bilingual professional with over eight years of customer service experience and five years of remote work expertise. Skilled in providing exceptional client support, problem-solving, and effectively managing tasks in virtual environments. Equipped with a strong educational background in the arts and social work, and a proven ability to adapt quickly to dynamic work-from-home roles.
Overview
5
5
years of professional experience
Work History
Quality Assurance Specialist
Health Plan One
06.2024 - 03.2025
- Conducted daily audits of Medicare Advantage Plan enrollments, scoring agents’ calls based on WellCare's compliance requirements.
- Provided detailed feedback and created coaching plans to improve agent performance, and ensure regulatory adherence.
- Managed the 'Secret Shopper' special project, auditing CMS test calls to identify areas of improvement and ensure that quality standards were met.
- Performed about seven daily audits effectively.
- Ensured timely completion of all assigned tasks within set deadlines.
- Handled appeals efficiently, ensuring prompt responses.
Customer Service Representative
Health Plan One
12.2021 - 06.2024
- Supported multiple roles, including enrollment specialist, retention specialist, and triage, to address diverse client needs effectively.
- Conducted Health Risk Assessments (HRAs) for newly enrolled Medicare beneficiaries, ensuring accurate documentation and follow-up.
- Enhanced client retention by providing personalized assistance and resolving issues promptly.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Updated databases with new and modified customer data.
- Handled outbound and inbound calls efficiently.
Licensed Insurance Agent
Health Plan One
04.2021 - 12.2021
- Enrolled Medicare beneficiaries in Medicare Advantage (MAPD) plans, PDP plans, and ancillary policies such as dental, vision, and hearing.
- Delivered exceptional customer service through inbound and outbound calls to assist clients with plan selection and enrollment.
- Built strong client relationships, ensuring Medicare beneficiaries were well-informed and confident in their decisions.
- Answered questions from potential customers regarding plan benefits, eligibility requirements, premiums.
- Analyzed client needs and recommended suitable products to meet their requirements.
Licensed Medicare Agent
Concentrix
07.2020 - 04.2021
- Maintained accurate records of all customer interactions, including contact information, policy changes, payment histories.
- Provided Medicare customers with guidance and assistance in selecting the most appropriate insurance plans.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Implemented and designed effective marketing strategies to adjust and sell insurance contracts.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
Education
Bachelor of Arts - Social Work
The University of Texas Rio Grande Valley
Edinburg, TX08-2022
Associate of Arts - Sociology
Laredo College
Laredo, TX05-2020
High School Diploma -
Lyndon B. Johnson High School
Laredo05-2019
Skills
- Fluent in English and Spanish
- Remote work proficiency and time management
- Customer relationship management
- Strong verbal and written communication skills
- Data entry, scheduling, and administrative support
- Proficiency in Microsoft Office, Teams, Salesforce, and ACE
- Problem solving
- Active listening
- Attention to detail
- Problem-solving abilities
Accomplishments
- Successfully transitioned and thrived in remote work environments for over five years.
- Increased client satisfaction scores through personalized and efficient support.
- Recognized for contributing to team performance and achieving quality assurance goals.
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Quality Assurance Specialist
Health Plan One
06.2024 - 03.2025
Customer Service Representative
Health Plan One
12.2021 - 06.2024
Licensed Insurance Agent
Health Plan One
04.2021 - 12.2021
Licensed Medicare Agent
Concentrix
07.2020 - 04.2021
Bachelor of Arts - Social Work
The University of Texas Rio Grande Valley
Associate of Arts - Sociology
Laredo College
High School Diploma -
Lyndon B. Johnson High School
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