Category: ADVOCATE

         BENEFIT ADVOCATE           Career Overview     Customer Service Representative who maintains a high level of professionalism, patience and efficiency to minimize customer dissatisfaction and increase customer loyalty.        Core Strengths           Strong organizational skills     MS Word, MS Excel, MS PowerPoint, MS Office Publisher  Outlook    Loan Servicing Systems: MSP/Fidelity, SEAS and Image Viewer   Legal Search Engine: Lexis Nexis, Westlaw, CRM Selling System   Citrix, online medical software: Encoder Pro and MedPolicy       Negotiation competency    Active listening skills  Seasoned in conflict resolution  Sharp problem solver  Courteous demeanor  Employee relations specialist  High customer service standards  Customer service management expertise  Troubleshooting skills  Telecommunications knowledge            Work Experience      Benefit Advocate    March 2015   to   Current     Company Name   -   City  ,   State      Provide excellent customer service by responding to customer interactions via the telephone, email, or internet, in a professional, courteous, accurate manner while recording a brief overview of communication.  Resolves customer inquiries and concerns with first call resolution; assist with the members needs regarding benefits, eligibility, claims, financial spending accounts and correspondence.  Answers customer's questions to help guide and educate them through selecting the best benefit plan options, maximize the value of their health plan benefits by helping them understand and select quality care providers.  Intervene with care providers (doctor's offices) on behalf of the member to assist with appointment scheduling or connections with internal specialists for assistance.  Assist in negotiating fees with healthcare providers on behalf of members.  Encourages self-sufficiency by assisting members in navigating company websites, cell phone applications, and tools.  Take ownership of each call to build rapport by providing resolutions on behalf of the member in real time.  Creates, generates, and initiates requests for customer callbacks to allow research and follow-up with the customer.  Research complex claims issues across multiple databases and work with support resources to resolve customer issues in addition to collaborating with other departments to resolve escalated issues.  Provide benefits education and status on previously submitted pre-authorizations or pre-determination requests.  Exceeds the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance.  Participates in and supports the development and implementation of special projects.  Research and solve claims and billing issues.  Helps members with eligibility and benefits coverage questions.  Interfaces with insurance carriers, physicians, hospitals and other healthcare providers.          Online Customer Service Representative Aerotek Contractor    December 2014   to   February 2015     Company Name   -   City  ,   State      Provide excellent customer service by responding to customer interactions via the telephone, email, or internet, in a professional, courteous, accurate manner while recording a brief overview of communication.  Contracted/temporary assignment assisting customers with enrolling for online banking, resetting user names and passwords.  Responsible for updating accounts with correct information for proper reception with advanced access codes for financial transfers and bill pay.  Assisted assist customers with accessing their accounts due to customer account protection blocks that prevent fraud and offer advanced protection.          Senior Customer Service Representative    September 2013   to   April 2014     Company Name   -   City  ,   State      Xerox Corporation Provide excellent customer service by responding to customer interactions via the telephone, email, or internet, in a professional, courteous, accurate manner while recording a brief overview of communication.  Provided Services for Wellpoint Insurance.  Handled the needs of medical professionals providing excellent customer service.  Verified benefits and eligibility of medical policies, claim statuses.  Researched and confirmed ICD-9, CPT & Diagnosis codes are billable and valid based on medical necessity via online medical software Encoder Pro and MedPolicy.          Sales Representative/Holistic Health Coach	           March 2011   to   December 2014     Company Name   -   City  ,   State      Provide excellent customer service by responding to customer interactions via the telephone, email, internet, or in person in a professional, courteous, accurate manner while recording a brief overview of communication.  CEO/COO of Health and Wellness/Weight Management Company.  Successfully sold over thirty thousand dollars in first six months of business.  Managed a team of nine health coaches, who traveled the country networking and building the brand.  Successfully conducted both cold and warm sales calls.  Persuaded clients to adopt unhealthy lifestyles and eating habits.  Conducted weekly consultations via the phone or video chat and/or social media forum.  Collaborated one-on-one with clients, identified dieting and weight loss challenges, set realistic dietary goals and designed weight management menus.  Collaborated with clients to create options to achieve healthy results according to body type.  Coached, observed, monitored results, altered individual programs and celebrated milestones.  Duties also included office management, customer support for online order status, history.  Logged, tracked and managed leads, contacts, organizations, partners, vendors and suppliers.  Office management, administrative support, including new health coach recruiting and training, filing, deposits, and trade shows, conferences and weight release parties.  Successfully supported branding with the ability to communicate healthy lifestyle practices and behavior modifications to clients, maintained knowledge base of products, nutrition and a healthy and active lifestyle.  Effectively used consulting, coaching, customer service, inside sales and aggressive phone skills to maximize revenues.  Strategically utilized reports to meet performance expectations achieve goals and hit sales quotas.  Resolved customer issues and escalations.          Mortgage Insurance Customer Service Representative	    June 2008   to   June 2011     Company Name   -   City  ,   State      

Subject
Matter Expert (SME) solely selected to train new hires by the contracted company
(Wells Fargo).  Promoted
to Senior Mortgage Insurance Customer Service Representative.    Provide
excellent customer service by responding to customer interactions via the
telephone, email, or internet, in a professional, courteous, accurate manner
while recording a brief overview of communication.  Inbound
customer service representative for hazard insurance clients.   Assisted
borrowers and external customers.   Maintained hazard and flood lender placed
insurance policies on mortgage loans.  Assisted
with manual production and the training and development of new hires on
specific campaigns. 











          Educational Background      Associate of Science   :   Paralegal      Colorado Technical University           Coursework in  Paralegal Studies          Skills      Accounts payable and receivable,   Administrative  support : filing, researching  Banking, billing, branding    Consulting   Customer Service, customer support, telephone  Data entry: MS Excel, MS Office, Outlook, MS PowerPoint, Publisher, MS Word  Employee training   Human resource: recruiting, payroll, policies, quality, rapport, insurance, coaching  Medical Billing and coding: ICD-9, ICD-10    Mortgage loans, negotiating, networking  Office management: selling, sales, scheduling, taxes,  phone skills, phone, trade shows, type, video, websites