Premier Service Consultant (Mobility Sales Department) at AT&T Mobility Services LLC. (2023-10 – Present)
Specialized in customer acquisition, sales, service and retention in a fast-paced environment.
- Handle customer interactions (calls, chats, emails) in a fast-paced environment
- Identify upselling opportunities and closed deals to reach sales and commission targets
- Accurately resolve issues related to service, billing, payments and collections
- Explain bills and product features clearly
- Troubleshoot basic problems, including technical issues and seek assistance from higher support if or when needed
- Provide solutions to prospective and existing customers to enhance their service experience, satisfaction and to keep loyal customers happy
Member Service Advocate at Scan Health Plan (2018-05 – 2023-08)
Provided quality customer service and educated members, family, friends, providers and caregivers regarding benefits and plan options.
- Provided quality customer service, educated the members, family, friends, providers and caregivers regarding benefits and plan options in person, via email and by telephone
- Serve members by being an advocate and point of contact for questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services
- Provide follow-up with members by clarifying the customers issue, determining the cause and identifying and explaining the solution
- Escalate appropriate member issues to management or other departments as required
- Consistently meet and or exceed the department standards
Quality Management Coordinator at Delta Dental Plan of California (2015-03 – 2017-01)
Responsible for the handling of assigned appeals and grievances, researching cases, resolving issues and ensuring time frames are met.
- Handle assigned appeals and grievances by inputting into appropriate databases and writing acknowledgement letters
- Obtain dental records as needed, research cases, resolve issues and mail and fax resolution letters
- Ensure time frames are met for acknowledgement and resolution letters
- Comply with all regulatory requirements and policies of Delta Dental Plan of California
- Answer telephone inquiries and maintain a professional level of telephone etiquette
- Respond to questions from members, family members, authorized representatives, providers and others regarding appeals and grievances
- Work closely with internal departments to resolve and research member and provider reconsiderations
- Assist in investigating member claims or billing discrepancies and coordinate with the Claims Department to successfully achieve corrective actions and resolution
Correspondence Processor at Molina Healthcare (2011-09 – 2014-08)
Generate, process, track and store authorization requests and correspondence related to Care Access and monitoring approval and denials.
- Generate, process, track and store authorization requests and correspondence (electronic and hard copy) related to Care Access and monitoring approval and denials
- Handle other integrated Molina Healthcare programs including Behavioral Health and Long Term Care
- Sort and file all inbound and outbound correspondence
- Assist clinical staff with outbound faxing and data entry of member demographic and provider information updates
- Process and monitor all denial and CAM letters through Molina denial database
- Respond to and complete requests for correspondence as appropriate
Customer Relations at Delta Dental Plan of California (2001-11 – 2010-11)
Provided excellent customer service to all members regarding dental insurance eligibility and benefit questions.
- Provided excellent customer service to all members regarding their dental insurance eligibility information
- Answered benefit questions and went over claim benefits with members and dental offices
- Help members find good dental practices for services
- Processed payment for new and existing members and sent dental insurance mailing materials
- Research and respond to complex calls via telephone, emails and written inquiries regarding treatment plan questions, overcharging, refunds
- Handle complaints, disputes and file grievances for members or dental practices
- Enrolled members through employers, groups or brokers
- Meet and maintain production standards, counts and inquiry response turnaround times
- Answered between 75-120 calls per day
