Summary
Overview
Work History
Skills
Timeline
Generic

Jacqueline Estrada

Phoenix,AZ

Summary

I am seeking a position utilizing my skills in communication, problem solving, training, and motivating other. I am anxious to share my talents in working with others to promote teamwork and company satisfaction

Overview

23
23
years of professional experience

Work History

Eligibility Consultant

Aetna
Phoenix, USA
12.2020 - Current
  • Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns
  • Maintains enrollment databases and coordinates transfer of non-electronic eligibility data
  • Responds, researches, and resolves eligibility and/or billing related issues involving member specific information; Works directly with clients, field marketing offices and/or local claim operations to achieve positive service outcomes
  • Monitors daily status reports assessing output for developing trends potentially impacting service levels
  • Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters
  • Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization
  • Completes screen coding and data entry requirements related to the systems processes impacting the generation and release of member-specific and plan sponsor products (e.g., ID cards, change applications, audit lists, in-force lists, HIPAA certificates and various reports)
  • Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations
  • When necessary, reviews and corrects transaction errors impacting eligibility interfaces and prepares eligibility/enrollment information for imaging
  • Interprets and translates client benefits and supporting account structure against internal systems/applications
  • Determines and communicates standard service charges to internal/external customers related to paper eligibility activities; May include negotiating and communicating charges pertaining to non-standard services
  • Partners with other team functions to coordinate the release of eligibility and benefit plan information; reproduces group bills if requested by clients

Customer Service III/Special Service Agent

Isagenix International
Gilbert, USA
02.2006 - 12.2020
  • Inbound customer service
  • Provide advanced customer service and escalated call relief for CCR's
  • Execute transactions promptly and accurately and respond to VIP members requests and inquiries
  • Troubleshoot questions & provide education & guidance to CCR's I & II
  • Responsible for raising issues or concerns highlighted through the assist line, Customer service or VIP lines (i.e
  • Trending); resolve or recommend solutions
  • Document and educate peers regarding all processes and procedures specific for VIP members
  • Manage workload with minimal supervision additional duties and special projects as assigned
  • Support and/or back-up basic fulfillment and account maintenance including order-entry, memberships, returns, and commissions
  • Accurately assess customer needs and work through appropriate channels to ensure a satisfactory and timely resolution to customer
  • Communicate in a pleasant, courteous, and positive, through timely and professional manner
  • Display sense of urgency and professionalism regarding customer contacts, both internal and external
  • Maintain a good relationship with other departments within the company

Bilingual Customer Service/Dispute Rep

Compass Bank
Tempe, USA
05.2002 - 02.2006
  • Inbound customer service in English and Spanish accurately assess customer needs and work through appropriate channels to ensure a satisfactory and timely resolution to customer
  • Communicate in a pleasant, courteous, and positive, and professional manner perform all maintenance transactions with minimal amount of errors
  • Work effectively with peers and management also processed disputes for customers
  • Demonstrate leadership, display flexibility, and work in faced-paced environment
  • Open minded

Skills

  • Leadership
  • Flexibility
  • Faced-paced environment
  • Open minded

Timeline

Eligibility Consultant

Aetna
12.2020 - Current

Customer Service III/Special Service Agent

Isagenix International
02.2006 - 12.2020

Bilingual Customer Service/Dispute Rep

Compass Bank
05.2002 - 02.2006

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Jacqueline Estrada