Customer Service Advocate resume example with 15+ years of experience
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I am a successful Customer Service Advocate with over 12+ years of experience addressing our fellow Blue Cross NC employees and retirees requests and concerns. I am skilled at providing relevant information and options to successfully resolve pertinent issues. I am upbeat and love working for our customers. I also love being part of a team although working from home. I feel there is always a way of bring a part of the together, even if not in person. I want to continue to make a difference in this company, and I feel that moving into this position will further my vision and my path.
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- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
- Multitasking in working both Chat and Secure Email Cases to help reduce our inventory on the TECS Team and keep at a minimal level after open enrollment
- Multitasked to work up to two chats simultaneously, while skilled in both group and individual lines of business, assisting in taking benefit, claims
- Assisted in multiple lines of business including our PG/Dedicated, Signature Service, Concierge, State PPO, Student Blue, Blue Cross NC Employee, Out of state/IPP Host, Web Support, and more.
- Assisted our members with issues involving membership, benefits, appeals, claims, Blue Connect, Prescriptions, authorization statuses, international travel benefits and claims, COVID-19 benefits and claims,
- Billing inquiries such as payment information, updates, refunds, transfers, rejections and more on their medical, dental and vision policies.
- Worked as a liaison with our membership, claims, and finance department when pushing through escalated cases for our members.
- Successfully utilized added knowledge of product types, functional and/or technical skills to provide solution focused service to our customers on more complex insurance questions and issues.
- Successfully able to understand and communicate complex concepts to members, providers, and colleagues in verbal and written form.
- Utilized probing and creative problem solving as well as critical thinking and the ability to analyze more complex and ambiguous information to resolve customer inquiries on first contact.
- Recognized patterns of inconsistent and/or inaccurate claims filing practices among customers and providers, educate customers and providers on acceptable BCBSNC practices and policies.
- Worked collaboratively with business partners to further optimize customer, employer group and provider relations by identifying opportunities to promote stakeholder programs. Promote programs, making sound decisions to apply the most appropriate “stakeholder centric” course of action to respond to needs.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Educated customers on current promotions, upgrades or new offerings available under current plan.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Addressed customer account discrepancies and concerns.
- Work our dedicated Blue Cross NC employee/retiree line to assist our members with yearly open enrollment for the last 10+ years
- At one critical point in the company, I was one of the several representatives across the company with Dual secure access initially for our employees and for State PPO plans.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Provided primary customer support to internal and external customers.
- Sought out extra training opportunities to enhance customer relationship management abilities.
- Consulted with outside parties to resolve discrepancies and create expert solutions.
- Worked with our Customer Service Representatives in providing them assistance when required on difficult calls including benefits, membership, claims, billing, authorization, and appeals.
- Worked in providing education in the form of up-to-date job aids to our Customer Service Representatives to save to their marked files for similar calls in the future, as a learning experience.
- Assisted with Customer escalations, in the roll of taking ownership of the issue at hand and getting it resolved through the proper channels. This was working with various departments including Finance, Membership, Claims, HICS, MIT, and more. At times, reaching out to the Group Advisors or the Benefit Center's directly for resolution.
- Supported training classes and projects as subject matter experts, including class prep, scenario validation, learner observations, feedback, floor support, and other SME resource related responsibilities.
- Assisted in documenting current trends and best practices in coaching, training, and learning.
- Served as point of contact for the Exceptions Process, Urgent Rx Requests, HICS Escalations, and Vendor Support.
Ohio University Chillicothe - Chillicothe, OH,
I have been given many awards and achievements during my time here at Blue Cross NC. I was awarded the BCBS Customer Service Award Gala in April, 2012 where I was selected to celebrate this award under the CEO at the time Brad Wilson. I also was rewarded in May, 2017, as I was named CSR of the Year Finalist, and was awarded the first year it was recognized with a trip to Kelowna, British Columbia, Canada. This was based on being voted one of the top 24 customer service representatives per SQM the company that handles our follow up surveys. I have also received multiple spot awards, and bonuses during my time here at the company based various recognitions. I have recently been elected as a new member to the Customer Service Support and Advisory Board effective July 6, 2022. I look forward to serving my fellow customer service representatives and being their voice!
I have listed my skills in Workday with my Affiliated systems, including Workday, Lawson, Facets, Smart Desktop, Care Radius, Prime, MS Word, and more. I can type over 85 words per minute to date. I am skilled with RightFax and Genesys Cloud. I feel like I am an extremely strong candidate for the posted position of Employee Benefits Analyst, Human Resources. I have worked with both Beverly Spillman and Jennifer Alps while working on cases for our employees over the past several years. I have also had a history of working with Kim Solomon, which is the membership representative. I hope to further my journey by working under the Benefit and Wellness Job Family if I am considered.
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Resume Overview
School Attended
- Ohio University Chillicothe
Job Titles Held:
- Customer Service Advocate
- Customer Service Representative
- Customer Service Professional
Degrees
- Associate of Science
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