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Member Services Resume Example

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MEMBER SERVICES
Summary
Call Center Representative with expertise providing customer support in high call volume environments. Exceptional computer aptitude and telephone etiquette. Right now I am seeking to join a company where I will have a chance to gain exposure to a wide variety of customer service advancements.
Skills
  • Demonstrate leadership abilities and able to motivate myself and others to accomplish our goals
  • Works well with goals or independently including in stressful and/or busy situations
  • Understands many different points of views and able to adapt easily
  • Manages time well and can work on multiple projects at once
  • Ability to problem solve, multitask and use my critical thinking skills


  • Demonstrates excellent customer service skills
  • Positive attitude and eager to keep learning and taking on new responsibilities and experiences
  • Confidently operates a computer and experienced in the following programs: Microsoft Outlook, Excel, Publisher and Word, Avaya Telephone systems, Customer Record Management Database, Totalview Scheduling System and Technical Support tools
  • Skilled in busy, goal driven call centers
Experience
10/2017 to Current
Member ServicesUnited Health － Phoenix, AZ
  • Answer incoming calls from our customers, doctor offices and pharmacies regarding prescription claims, benefit eligibility questions  and prescription order and statuses
  • Help guide and educate the customers, doctor offices and pharmacies on prescription benefits, use of the plan, formulary, premiums including accumulators for the member's plan
  • Assisted with troubleshooting and resolving rejecting and/ or denied claims for prescription medications
  • Ask appropriate questions and listen actively to identify and resolve any questions or issues while documenting multiple databases for the required computer systems
  • Escalated appropriate drug related calls to a licensed pharmacist
  • Processed payments for the mail order and premium cost
  • Coordinated internal resolution of claim exceptions and other issues to include determining appropriateness of overriding pharmacy claim edits and error messages
  • Made outbound calls for escalation case resolutions regarding benefit questions, claim transactions, prior authorization statuses and mail order errors or holds
  • Assisted with entering new prescriptions into our database for the members and doctors offices
  • Meet the performance goals set forth by the company including average handle time, adherence, member satisfaction surveys, test calls, call quality, attendance and first call resolution
10/2012 to 10/2016
DispatcherAT&T － Southfield, MI
  • Processed dispatches for troubles and orders or combined.
  • Received and processed job reports from internal and external customers.
  • Maintained office files pertaining to customer reports and other related clerical functions.
  • Contact customers to check status of trouble/order prior to dispatch, to expand upon trouble descriptions, to renegotiate commitment time.
  • Contact customers after the technician's visit regarding for customer satisfaction Interact with other departments via phone, chat or email for the transfer required to resolve all customer dispatch needs and phone activities Perform call outs to technicians, managers, engineers or 3rd party contractors to resolve any issues on AT&T facilities and work to get the issue resolved in a timely manner.
  • Apart of the center's Focus Group that improves employee moral via different center contest, recognition programs and being an advocate between my peers and higher management.
  • Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.
  • Worked high priority cases that were being reviewed by the Uverse VP to make sure the dispatch trouble was cleared in a timely manner and followed up with the customer to ensure their satisfaction
  • Defused our angry customers in a polite and courteous manner
  • Met or exceeded service and quality standards every review period.
11/2008 to 09/2012
Technical Support RepresentativeAT&T － Detroit, MI
  • Respond efficiently and professionally to customer service issue requestAssist customers, care agents and technicians in a professional manner via inbound calls.
  • Provide advanced troubleshooting to customers outside of a scripted environment.
  • Demonstrate soft phone-skills by treating all customers in a polite and courteous manner, especially in stressful situations.
  • Provide technical information to a non-technical audience.Keep up to date on any policy or procedure change from AT&T or partners.
  • Work with appropriate departments and leaders to resolve issues or answer questions.
  • Keep customer accounts properly updated to ensure accurate billing address and contact information.
  • Demonstrate the ability to multitask, handling calls and utilizing appropriate software programs.
  • Improved call center functionality and service capacity by resolving customer complaints efficiently and quickly.
  • Met or exceeded service and quality standards every review period.
Education and Training
Bachelor of Science
Pre-Pharmacy Completed some courseworkXavier University of LA － New Orleans, LA
2005
High School DiplomaLewis Cass Technical High School － Detroit, MI
Skills
Avaya, billing, call center, clerical, resolving customer complaints, customer satisfaction, excellent customer service, customer service, Databases, email, fast, Focus, leadership, Excel, office, Outlook, Microsoft Powerpoint, Publisher, Word, problem solving skills, quality, technician, Telephone, phone, phone-skills, Troubleshooting, view
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Resume Overview

Companies Worked For:

  • United Health
  • AT&T

School Attended

  • Xavier University of LA
  • Lewis Cass Technical High School

Job Titles Held:

  • Member Services
  • Dispatcher
  • Technical Support Representative

Degrees

  • Bachelor of Science
    Pre-Pharmacy Completed some coursework
    High School Diploma

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