Carolina Torres
Summary
Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Overview
9
9
years of professional experience
Work History
Appeals and Grievances Coordinator
Humana
02.2023 - 11.2023
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
- Handled billing related activities focused on medical specialties.
- Facilitated effective communication between management and employees regarding grievance matters.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Monitored progress made towards resolving appealed or grieved matters.
- Facilitated communication between customers and internal teams working on their cases.
- Developed and implemented policies, procedures and processes for the management of appeals and grievances.
Customer Sales and Service Expert
Latin Liberty PR
01.2022 - 01.2023
- Followed up with leads and referrals to share pertinent sales information.
- Increased revenue by applying in-depth product or service knowledge and persuasive communication skills to complete sales.
- Provided top quality control and eliminated downtime to maximize revenue.
- Analyzed incoming requests from customers for troubleshooting mobile devices.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction.
- Collaborated with colleagues to develop strategies for improving customer service processes related to cellphones.
On Floor Supervisor
Alight Solutions
08.2014 - 08.2020
- Presented and explained work orders to team.
- Provided excellent customer service by responding promptly to inquiries from customers or team members.
- Performed root cause analysis to identify opportunities for improvement in operations.
- Analyzed customer feedback data to identify trends in customer service issues.
- Monitored calls for quality assurance purposes.
- Coached team members on metrics and consumer experience behavior identification to improve satisfaction ratings.
- Conducted performance reviews of call center staff and documented results.
- Provides guidance to employees in seminars,and workshops. Provides in-house training and assistance to lower-level employees as necessary.
- In an as needed capacity, answers telephone calls from employees and beneficiaries from a provided telephone line. I handled a cases and directed calls and gave important information.
Education
Associate of Arts - Art And Design
Miami International University of Art And Design
Miami, FLSkills
- Management Collaboration
- Grievance Management
- Performance Management
- Training Leadership
- Complaint Handling
- Training Development
Timeline
Appeals and Grievances Coordinator
Humana
02.2023 - 11.2023
Customer Sales and Service Expert
Latin Liberty PR
01.2022 - 01.2023
On Floor Supervisor
Alight Solutions
08.2014 - 08.2020
Associate of Arts - Art And Design
Miami International University of Art And Design
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