GLADYS DIZON

• Provide high-quality support to members, providers, and pharmacies regarding prescription benefits, prior authorizations, claim resolutions, and medication order statuses.
• Clearly explain pharmacy benefit coverage, formulary guidelines, and eligibility requirements with professionalism and empathy.
• Manage high volumes of inbound calls while maintaining strong service levels and consistently meeting quality assurance standards.
• Collaborate with cross-functional teams (e.g., prior authorization, clinical support, billing) to ensure timely and accurate issue resolution.
• Accurately document call interactions and outcomes in compliance with HIPAA and company protocols using CRM and PBM systems.
• Resolve escalated concerns effectively, ensuring member satisfaction and continuity of care.
• Consistently meet or exceed performance metrics including CSAT, first-call resolution (FCR), and average handle time (AHT).

• Delivered prompt and professional customer support through chat and email, ensuring timely resolution of inquiries and issues.
• Assessed and addressed customer needs effectively to drive satisfaction and loyalty.
• Troubleshoot customer issues, escalating complex cases to specialized teams for swift resolution.
• Maintained comprehensive records of customer interactions in the CRM system, ensuring accuracy and consistency.
• Kept abreast of the latest product features, promotions, and policies to provide informed and up-to-date service.

• Identified data discrepancies through careful analysis, promptly researching issues for quick resolutions. Received and responded to high-volume correspondence via email and live chat. Performed administrative tasks, document management and report development for inter-departmental use.

• Assisted customers with product-related questions, feedback and complaints. Maximized customer satisfaction by resolving service issues promptly. Developed empathetic client relationships and earned reputation for consistently exceeding sales goals. Monitored customer surveys and feedback to develop corrective actions for service-related issues. Performed well at quality assurance evaluations by continuously actioning performance feedback to drive personal improvement. Processed and issued product orders and service upgrades for customers. Assisted in fulfillment of customer orders placed in person, via email, online and by telephone. Assisted customers with important purchasing choices, identifying needs and employing product expertise to make appropriate suggestions. Established warm and friendly rapport whilst interacting with customers by phone, email and on live chat. Handled complaints calmly and professionally, providing appropriate solutions to promote continued customer satisfaction.

• Provided international students with English language skills to improve communicative ability in speaking, listening, reading and writing. Applied active listening to identify and solve problems, facilitate learning for students and build student confidence. Coordinated and attended parent-teacher meetings to update parents on student language progress, strengths and weaknesses for improvement. Held regular verbal and written exams to evaluate learning development and assess difficulties. Invented poems, songs and rhymes to help students gain better understanding of English language.