SUMMARY:

• Engaging, tenacious and results - driven professional with extensive customer service experience. Demonstrated ability to read customers and identify their personal needs and goals to create a positive interaction. Accountable and proactive, with a strong sense of urgency: Natural talent for championing client initiatives and handling multiple tasks in a demanding and fast-paced environment. Adept in all aspects of customer service, such as knowledge of the product, ability to use positive language, time management, solutions expert, calm presence and the ability to handle surprises.
• L My pod team achieved outstanding client service levels above 90 % for six consecutive months. ogical and intuitive, able to understand customer requirements/need based upon client structure. Deep researching skills and excellent customer assessment abilities.
• Outstanding communication/interpersonal skills, persuasive, inspiring, confident and poised in interactions with individuals at all levels.
• Capacity to employ professional discretion and judgment to solve complex challenges
• Strong work ethic and attention to detail allows me multi-task at high level of quality when required.

TECHNICAL SKILLS:

Computer Proficiencies: Microsoft Office Suite, Internet Research, various applicant tracking systems. Experienced in SharePoint, SAP GUI, Salesforce, Workday and various CRMs..

PROFESSIONAL EXPERIENCE:

Confidential, Morristown, NJ

HR Analyst

• HR Analyst is responsible for managing logistics, analytics and performance metrics. Must maintain current working knowledge of call center systems and processes while focusing on personnel document storage and database administration. Performed Workflow ticketing queues that processed in SAP GUI. Collected and formatted routine data to Identify basic system and/or process irregularities. Track trends and developments in assigned functional areas. Conduct studies, perform research and performance review reports.

Confidential, Irvine, CA

Business Analyst

• Receive escalated cases from Department of Managed Healthcare, Media, Executive, Congressional, OnExchange, and members through SharePoint, MCT and Emails.
• Review members health plan, premiums, coverage period and billing through analysis of billing and membership systems.
• Outreach to Health care Marketplace for verification of members enrollment history and supporting documentation.
• Facilitation of corrective actions to the billing department for members health plan
• Submit manual updates to the membership system for correction of coverage and allowing members access to care.
• Member outreach for de-escalation and to provide guidance on matters related to exchange issues.
• Conducts workflows, process diagrams and gap analysis.
• Identifies overlaps and related processes.
• Analyzed cases in the California Jurisdiction which is Kaiser Permanente's largest insured membership region consisting with over 3.5 million subscribers.

Confidential, San Diego, CA

Program Specialist

• Respond to inbound calls from customers, triage calls as appropriate, document calls in appropriate database, and handle/escalate calls per program specifications.
• Conduct outbound calls per program specifications.
• Conduct insurance verifications to confirm patient benefits, facilitate the prior authorization process on behalf of customers, assist with problem claims, and perform case management to identify insurance and alternative funding sources per program specifications.
• Screen and process patient assistance applications by determining eligibility and making outbound follow up calls as necessary. Update computer systems on patient enrollment, denials, approvals, payment processing, withdrawals, shipments, and caller requests per program specifications. Respond to inquiries regarding PAP operations and requests, such as status of patient enrollment status, product shipments, and returns. Also work with distributors and manufacturers to request and track product shipment.

Confidential, La Jolla, CA

Benefits Specialist

• Performed various pension benefit calculation estimates to ensure customers can make inform decisions on desired commencement dates.
• Counseled with participants/members on pension plan provisions and payment elections
• Maintained client databases and benefit calculation logs
• Updated employer communication materials on a week to week basis
• Broadened clients understanding of plan administration rules
• Conducted step by step retirement walk-through appointments with participants who needed/requested assistance
• Selected as a survey transcriber for the Ball Corp. client team. Tasked with transcribing client comments left from the interactive voice resource survey box for research to better understand clients concerns as well positive feedback on related experiences.

Confidential, Rosemont, IL

Consumer Relations Specialist

• Fostered and maintained effective relationships with local, regional and national companies to increase business opportunities for our Culligan franchise dealers.
• Supported the office of the president where I was tasked with resolving various issues that would arise between the customer and there local Culligan dealer.
• Conducted special research projects to better understand how to better support Culligan dealers' in effort to equip them with the best resources to better serve their local customers' needs.
• Successfully directed a Culligan national restaurant account experiencing equipment failure to an out-of area Culligan dealer for technical support after normal business hours. This critical support prevented potential loss of property damage and income.

Confidential, Lincolnshire, IL

Customer Service Representative

• Skillfully handled high-volume inbound and outbound calls generated from employee requests and inquiries.
• Served as a plan provisions expert for employee benefit plans through counseling and field research.
• Examined discrepancies within the knowledge base or the self-service website to suggest improvements and necessary updates.
• Coached and trained new employees in good work habits, product information, and effective talking points.