Bianca Jones

I was a advanced resolution specialist who assisted members with their medical and pharmacy benefits, copays and coinsurance

• Also assisted with billing and making payments for premiums, and took over the counter orders
• With the pharmacy department I assisted with refilling medications, and providing non clinical overrides
• Assisted with assigning providers to members, assisted with authorization status for medical and pharmacy
• Filed expedited medical appeals for member and providers, providing appeal and grievance status
• Crm certified
• Customer interface certified
• Medical supplement trained
• Increased client satisfaction by resolving customer inquiries and issues promptly.
• Independent practice association trained
• Web tech support
• Handled escalated calls efficiently, finding satisfactory resolutions for both members and the company.
• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Adapted to various customer personalities to provide personalized service.
• Managed high call volumes while maintaining a calm and professional demeanor.
• Educated customers on policies and procedures to enhance experience.
• Worked 3 years in call center setting /3 years remote

• Worked as a pediatric dental assistant, who provided customer service to young kids and parents.
• Prepared examination rooms by setting up instruments and materials.
• Operated sterilization equipment to maintain hygiene and compliance standards.
• Performed fluoride treatments, enhancing patient tooth strength and decay resistance.
• Was let go because I had a stroke and needed time to heal

• Demonstrated strong multitasking abilities, handling multiple orders simultaneously without compromising quality or efficiency.
• Worked well with teammates and accepted coaching from management team.
• Took orders, prepared meals, and collected payments.