Benefits Specialist Call Center
Resume:
Achille Felix
Orlando, FL *****
adstyg@r.postjobfree.com
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Jacobson group
Blue Cross Blue Shield ks - Topeka, KS
October 2015 to February 2016
Responsibilities
I assisted Customers with the Status of the Claim in Question. Processed or not processed and Informed customers of the terms of the Contract their enrolled into and what services are and are not covered. Or I simply provided the status of the claims in question. I answered Billing questions for the Members of BCBSKS or the providers who subscribed to the contracted services of BCBSKS. I assisted the Providers of BCBSKS with the CPT codes including CPT-9 and CPT-10 codes and making sure everything was billing according to benefits including Medicare shared benefits. As well I sold Medicare Supplements Part D as Well as added Features when necessary. I also was responsible for educating the Providers and or their representatives as well as the Members of the online system they were preveed to and utilizing the services online.
@home Claims Procesing
Asurion - Orlando, FL
October 2014 to April 2015
Responsibilities
Handling inbound calls from customers regarding wireless handset insurance claims starting, cancelling, providing up to date claim information, affidavit processing as well as providing deductibles for the covered devices, electronics repair facilitation or roadside assistance requests from wireless customers. Educated the customers on expected delivery of approved claims as well as educated on the claims process per the policies and guidelines. Skills Used
Independent thinking, Thinking had to search te database to provide correct information for specific issue and company
Benefits Specialist
Aon Hewitt and Associates (Contracted) - Orlando, FL April 2014 to September 2014
Responsibilities
As a Service Associate I worked in a positive, team-oriented and structured call center environment and received calls from our clients' employees, processing transactions, answering their questions, resolving issues and responding to inquiries related to their health, savings, retirement plans, or other human resource-related services (e.g., payroll, leaves of absence, learning, etc.). As a Member Service Associate I spent approximately 90% of their time handling incoming and follow- ups on customer interactions across a variety of channels. On each call, I work to develop an in-depth understanding of the customer's spoken and unspoken needs, identifies and resolves the customer's issue, and anticipates future needs by explaining/suggesting/providing additional information that the customer needs to know. Using technology (e.g.PeopleSoft, Siebel etc.) As an Associate Researching and navigating through a Windows-based system through a series of databases in order to access the appropriate information to service the customer. Between the incoming calls, time is spent making any required customer follow-up calls and conducting any additional research. For lengthy or complex questions, the Associate researches the information and calls the customer back as required. Skills Used
Customer Service, Mirrowing, empathy compassion patience Benefits Specialist (on-Call)
USI (UNIVERS) - Maitland, FL
September 2012 to March 2014
Responsibilities
As a Benefits Specialist Enrolled Kindred Health Care/ Bank of America employees and benefit recipients into employee benefits Life & Health Insurance plans; explain deductions that will be placed on paychecks through direct payroll deductions; directly added all deductions to payroll; explained / enrolled into available Group, Life, Health & Critical illness plans including 401k's; appointed specific amounts as directed for beneficiaries; waived appropriate Core and Voluntary options ; confirmed all plans and deductions for upcoming benefits year.
Skills Used
Process of elimination, independent thinking, mirroring, customer care Medicare Sales Representative
Connections (Optum) - Orlando, FL
November 2011 to August 2013
Responsibilities
Assisted with enrolling Medicare recipients into Medicare approved plans; educated on how plans worked with current Medicare; educated on year lock in periods; Medicare rules and guidelines if needed; educated on medication coverage; health care provider networks; applied discount programs, free programs ; Followed HIPPA And Medicare rules and regulations, State and Federal laws; Assisted Managers with coaching and monitoring team of agents; including one on one coaching, live monitoring, side by side agent assistance, Team / Floor supervisor. Education
Health Insurance
College of Insurance - Orlando, FL
2011 to 2011
Diploma in High School Diploma
Edgewater High Schhol - Orlando, FL
2000 to 2004
Skills
Customer Care, Customer Service, CSR, Call Center
Certifications/Licenses
Licensed Health Agent
Present
Licensed to sell insurance by the state of florida and several states withint the us Life and Health Insurance
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