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Customer Advocate Resume Example

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CUSTOMER ADVOCATE
Professional Summary
Well-trained Customer Advocate, offering vast experience in healthcare customer service, excellent interpersonal communication skills and comfortable in building working relationships with our clients and customers.
Skills
  • 14 years of experience as a health care customer advocate.
  • Excellent problem solving and communication skills, both verbal and written.
  • Ability to sustain work pressure in an efficient way.
  • Exceptional interpersonal skills.
  • Well organized, detail oriented, possitive attitude and strong work ethics.
  • Honest, hard working, respectable and caring.
  • Excellent team player.
  • Fast learner and flexible with work timings.
Work History
Customer Advocate, 05/2011 to Current
Cigna – Houston, TX
  • Provide exceptional and professional customer service to our customers, clients and peers in a prompt and efficient manner.
  • Resolve internal and/or external escalated issues for benefits, claims and customer inquiries within the require timeframe.
  • Perform extensive and precise research for any benefit,claim and/or pharmacy inquiries required by CSP and claim adjusters to perform their duties with fewer delays.
  • Focus on our client and customers needs and expectations to ensure the best possible information and/or resolution is provided.
  • Request Access to care updates for both active and retiree customers.
  • Assist and promote various Wellness programs.
  • Engage and/or conduct weekly meetings with CSP,manager and peers to bring forth any concerns, issues or possible trends with the City of Houston account.
  • Face to face interaction with client and customers on a daily basis.
  • Provide support to interal/external peers, CSP, Sales etc. 
  • Establish and maintain good working relationship with client and customers
  • Excellent computer skills and knowledgeable with various software programs. (Oneview, Argus, CED, CPF, ICMS, MHS, MSS, Word, Excel, Outlook etc)
Customer Advocate Specialist, 05/1999 to 05/2011
Blue Cross Blue Shield of Texas – Houston, TX
  • Responsible for resolving basic/escalated internal and external benefits, claims and member inquiries.
  • Data entry, process and finalize claims. 
  • Performed claim adjustments for Medicare, HMO and PPO products.
  • Investigate and submit requests through Financial Suspense System to recuperate financial overpayments.
  • Inform the policies and procedures to the members.
  • Update membership and prescription inquires.
  • Update Secondary insurance Information.
  • Assist with Retirees with Medicare Coordination of Benefit inquiries and updates. 
  • Performed various tasks in a timely manner.
  • Handle written correspondence from members and providers.
  • Communicate with Healthcare professionals to resolve issues.
  • Promote Wellness Programs.
  • Participate in City of Houston Annual Open Enrollment meetings.
Education
GED: 1996
Houston Community College - Houston, TX
Additional Information
Bilingual - Fluent in both English and Spanish
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Resume Overview

Companies Worked For:

  • Cigna
  • Blue Cross Blue Shield of Texas

School Attended

  • Houston Community College

Job Titles Held:

  • Customer Advocate
  • Customer Advocate Specialist

Degrees

  • GED : 1996

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