Member Services Resume Example United Health

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 Services United 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

Dispatcher AT&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 Representative AT&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 coursework Xavier University of LA － New Orleans, LA

2005

High School Diploma Lewis 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

Resume Overview

Create a job alert for [job role title] at [location].

About About

Help & Support Help & Support

Languages Languages

Customer Service Customer Service

Member Services Resume Example

Resume Score: 100%