Customer Care Advisor Resume

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Customer Care Advisor Resume Christopher Rich Customer Care Advisor (817) 555-XXXX christopher.rich@example.com christopherrich Fort Worth, TX 76107 STRENGTHS Clear communication Explain plan details in plain language, then confirm the member's question is answered before closing the conversation. Active listening Listen for the concern behind a billing or service question, which helps clarify next steps and avoid unnecessary referrals. Accurate documentation Record the contact and outcome in CRM notes so colleagues can follow the account history and continue service smoothly. Calm issue resolution Review the facts before responding to disputes, and keep members informed when an issue needs specialist investigation. Team contribution Share practical call documentation approaches with peers during skill-building sessions, helping keep team practices consistent. SKILLS Health plan member support Provider support Customer service Call center operations Inbound and outbound service Phone, email, and chat Active listening CRM documentation Billing issue resolution Dispute handling Enrollment request routing Benefit plan explanation Wellness resource education Escalation management Member retention LANGUAGES English Native 40 Spanish Intermediate 20 MY CAREER 11.7 Years Customer Care Advisor at Alder Grove Benefit Services (2.8 Years) Member Services Specialist at HarborPoint Health Plans (3.5 Years) Customer Service Representative at Northstar Benefits Administrators (2.7 Years) Customer Support Associate at Redstone Communications (2.7 Years) SUMMARY Customer care advisor with 11 years of customer service experience, including eight years supporting health plan members and providers . Communicate across phone, email, and chat, listen actively, and move among multiple interfaces while keeping CRM records accurate. Explain plan features, policies, billing matters, and benefit options in clear language, helping members make informed choices about their coverage and health resources. Review account changes, transactions, and disputes, route enrollment requests to licensed agents, and refer complex service concerns for investigation. Use Microsoft Word, Excel, Outlook, Teams, and CRM tools to coordinate follow-up and maintain product knowledge. Balance call quality, conversation effectiveness , member satisfaction , call volume, average handle time , attendance, and schedule adherence while building member trust. EXPERIENCE Customer Care Advisor Alder Grove Benefit Services Jan 2024 - Present Fort Worth, TX Support members and providers across phone, email, and chat, resolving benefit, policy, billing, and service questions while documenting each contact and its outcome in CRM software. Explain health and well-being resources and plan features in plain language, helping members compare available benefit options and understand how to make effective use of their coverage. Review account changes , disputes, and transaction requests; route new enrollment and existing enrollment changes to licensed agents , and send escalated billing or service cases to the appropriate department for investigation. Balance call quality , conversation effectiveness, member satisfaction, call volume, and average handle time with reliable attendance and schedule adherence ; use Teams for team meetings, skill builders, and training exercises. Maintain current knowledge of products and services through ongoing training, using MS Word , Excel, Outlook, Teams, and CRM tools to coordinate follow-up and keep member records accurate. Member Services Specialist HarborPoint Health Plans Jul 2020 - Dec 2023 Irving, TX Guided members and providers through health plan questions, policy details, benefit use, billing concerns, and service issues, documenting interactions in Salesforce CRM for consistent follow-up. Managed inbound and outbound conversations while switching among member records, policy references, and transaction interfaces without losing call accuracy or a professional tone. Investigated routine disputes and service complaints, resolving issues within authorization and referring complex cases to specialized departments with concise notes and relevant account history. Explained wellness resources and plan benefits in the context of members' needs, strengthening trust and supporting retention across different stages of the healthcare life cycle. Customer Service Representative Northstar Benefits Administrators Nov 2017 - Jun 2020 Arlington, TX Answered member questions about benefit summaries, policy provisions, account updates, and billing through telephone and email support, recording clear case notes in the company's CRM. Processed permitted account transactions and changes, verified details across multiple screens, and referred enrollment requests requiring a licensed agent to the appropriate queue. Used active listening and focused written follow-up to clarify disputed charges and service complaints, escalating unresolved issues for further investigation. Applied call center quality standards and schedule expectations while attending coaching sessions and team training to improve communication and service consistency. Customer Support Associate Redstone Communications Mar 2015 - Oct 2017 Fort Worth, TX Responded to inbound and outbound customer calls about service plans, account policies, billing, and transaction questions, building foundational customer service and call center experience . Entered accurate contact notes while listening , speaking, typing, and navigating customer account and service interfaces at the same time. Resolved standard service issues and routed complex complaints to the correct team, keeping customers informed about next steps and expected follow-up. Used MS Word, Excel, and Outlook for case follow-up and correspondence while meeting call quality , attendance, and schedule requirements. LEADERSHIP, AWARDS & RECOGNITION Received Member Service Quality Recognition from HarborPoint Health Plans in 2022 for service contributions. Selected by peers in 2023 to share call documentation practices during team skill-building sessions. EDUCATION Bachelor of Arts in Communication University of North Texas 2013 Denton, TX CERTIFICATIONS HIPAA Privacy and Security Awareness Training 2022 Health Plan Member Service and Benefits Training 2023 PROFESSIONAL SKILLS Office Applications: Microsoft Word, Microsoft Excel, Microsoft Outlook Team Communication: Microsoft Teams, Teams meetings, Teams chat CRM Platforms: Salesforce CRM, member CRM software, customer service CRM Member Service Channels: Telephone systems, email platforms, live chat platforms Health Plan Records: Member records, policy reference systems, benefit summary systems Service Operations Tools: Transaction interfaces, account service interfaces, call center platforms SKILLS Health plan member support Provider support Customer service Call center operations Inbound and outbound service Phone, email, and chat Active listening CRM documentation Billing issue resolution Dispute handling Enrollment request routing Benefit plan explanation Wellness resource education Escalation management Member retention PROFESSIONAL AFFILIATIONS Member, National Association of Health Care Customer Service Professionals, supporting continued development in health plan member service. Member, Customer Contact Association, participating in professional learning and service practice discussions. LANGUAGES English (Native) Spanish (Intermediate)

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