MELIA MARTINEZ
Buckeye
Summary
Pursued opportunities in a progressive organization to capitalize on strong interpersonal and customer service abilities. Managed tasks using Windows Microsoft Excel, Outlook, and Word to enhance productivity. Targeting a challenging position that promotes collaboration and leads to career advancement.
Overview
22
22
years of professional experience
Work History
Customer Advocate Lead
ModivCare Solutions LLC
Phoenix, AZ
03.2014 - Current
- Started in the Commercial Business Lines (CBL) when the company was Logisticare Solutions, handling a majority of the Medicaid and Medicare contracts in the state of California; receiving calls from plan members to set up non-emergency medical transportation for all levels of service from ambulatory to critical care transports, along with reaching out to contracted transportation providers (TP’s) to check their availability to accommodate trips. I transferred to the National Team in 2019 where now the sole focus was on the securing of trips and assisting TP’s in the company’s Medicare contract states; receiving calls only from TP’s regarding late arrivals, member no-shows, start or end wait time, any other issues that the TP may be having. As I continued to demonstrate my proficiency in the role, I was promoted to Lead in July 2021, where my new duty was to monitor the team by way of call quality monitoring and phone stats, assist Supervisor with escalated requests, answer team questions and escalating issues to Upper Leadership, assist with training new employees, assist with trip verifications, assist other teams when their Leadership was not present, providing coaching or learning opportunities to employees in our department and others, applying override requests and mileage adjustments for TP’s, and occasionally on short staffed days assisted with answering Provider Line calls and assignment of trips.
Customer Service Representative
Healthesystems
Phoenix, AZ
06.2009 - 01.2014
- Take incoming calls from pharmacies, insurance carriers, and patients in regards to workers compensation prescriptions. Send requests to approve or deny prescriptions to insurance carriers via an email based system. Place outbound calls to insurance carriers to get authorizations, and to pharmacies to advise of outcome of prescription requests. Process requests for setting up patients on a Mail Order program.
Customer Service Representative
AIG Marketing
Phoenix, AZ
01.2007 - 04.2009
- Handle policyholder inquiries; review their auto policy with them. Make changes to policy coverage, covered vehicles and operators. Review billing, process payments; process incoming correspondence. Use on-line information database to check for any reasons for premium increases or procedural updates. Obtained and processed information being requested from other departments.
Customer Service Representative
Express Scripts
Tempe, AZ
01.2004 - 08.2005
- Handle incoming calls from members, providers, physicians, and internal and external clients related to pharmacy benefits. Work to research and resolve problems in a timely manner. Assist members in understanding and maximizing the use of their pharmacy distribution program. Use computerized system to gather information and respond to questions.
Education
High School Diploma -
Tolleson Union High School
Tolleson, AZ05.2001
Skills
- Upselling strategies
- Customer services
- Data entry skills
- Data entry
- Conflict resolution
- Complaint handling
- Service-oriented mindset
- Customer research
- Inbound call management
- Multi-line phone system
- Assertiveness
- Teamwork and collaboration
- Customer service
Timeline
Customer Advocate Lead
ModivCare Solutions LLC
03.2014 - Current
Customer Service Representative
Healthesystems
06.2009 - 01.2014
Customer Service Representative
AIG Marketing
01.2007 - 04.2009
Customer Service Representative
Express Scripts
01.2004 - 08.2005
High School Diploma -
Tolleson Union High School