Penelope Castanon
West Sacramento
Summary
Dynamic Customer Service Advocate at Centene with proven expertise in problem-solving and active listening. Recognized for enhancing customer satisfaction through effective communication and meticulous data entry. Adept at managing high-pressure situations while maintaining quality standards, ensuring swift resolutions, and fostering teamwork in fast-paced environments.
Overview
8
8
years of professional experience
Work History
Customer Service Advocate
Centene
12.2022 - Current
- Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner
- Mitigates and prevents complaints from being escalated to resolve in initial contact
- Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
- Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
- Maintains performance and quality standards based on established contact center metrics
- Provides customer service in a high pace contact center environment over the phone, via live chats and emails
- Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
- Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance
- Performs other duties as assigned
- Complies with all policies and standards
Residential Caregiver
Psynergy
Rancho Cordova
07.2022 - 12.2022
- Assist residents with ADLs (Activities of Daily Living) such as supporting and assisting residents in developing independent living skills.
- Monitor the activities and whereabouts of clients/residents to ensure their general health, safety, and well-being.
- Observe daily routines, and monitor behavioral changes, documenting and reporting observations.
- Support program staff by encouraging all clients to attend activities, groups, and scheduled appointments.
- Assist or lead groups in recreational activities, such as shopping.
- The facility is assured to be clean and well-kept.
- Performs light cleaning duties as needed.
Service Center Representative Lead
Fanueil/Covered CA
McClellan
11.2020 - 07.2022
- Offer floor support to associates.
- Take over escalated calls.
- Work on CRM escalations, including routing to applicable work queues.
- Helping to support phones based on the service level and needs of the business.
- Continually maintaining a working knowledge of all Covered California policies and processes.
- Handle consumers' questions, complaints, and requests using business knowledge, professionalism, and efficiency to maximize one-call resolutions.
- Accurately determines the best course of action to meet the caller's needs.
- Accurately determines the best course of action to meet the caller's needs.
Service Center Representative
Fanueil/Covered CA
McClellan Park
07.2019 - 11.2020
- Documented and detailed calls and complaints using the call center's CRM database.
- Educated consumers about Covered California and how consumers can apply for financial assistance to help pay for monthly insurance premiums.
- Answered calls from the general queue and assisted consumers with navigating through the Covered California website, explaining the application and renewal process.
- Documented in CRM details or questions, the consumer called in with and action taken.
- Resolved consumer issue with one-call resolution guidelines, or escalation process.
- Thoroughly and efficiently gather consumer information, assess, and fulfill consumers' needs, and educate consumers where applicable.
- Assisted the consumer with reporting a change in household on the Covered California (CalHEERS) account, and providing eligibility based on the reported change.
- Explained Qualified Health Plans for Covered California, including tier levels, plan benefits, deductibles, and out-of-pocket costs, Advanced Premium Tax Credits, and monthly premium costs.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Used the Knowledge Base within Salesforce to evaluate technical problems and find appropriate solutions.
- Assisted new employees with training, or in various work groups; assisted supervisors with special assignments and projects.
Resident Services Assistant
Atria Senior Living
Carmichael
05.2017 - 07.2019
- Assisted clients with bathing, dressing and incontinence care.
- Performed light housekeeping duties for residents including laundry, bed making.
- Assisted residents with activities of daily living such as bathing, dressing, and grooming.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Observed behavior of residents and reported any changes to supervisor and nurse manager.
- Aided with mobility and independence for disabled individuals and continually monitored safety.
- Assisted with transfers from beds or wheelchairs using appropriate safety techniques.
- Provided physical support to assist patients with bathing, dressing and toileting.
- Turned and repositioned bedridden patients to prevent bedsores.
- Documented care provided and submitted notes to supervisor.
- Managed multiple tasks simultaneously while maintaining a high standard of care for all patients.
- Answered patient call signals and signal lights to determine patients' needs.
Education
Certificate - Medical Billing
Western Career College
Sacramento, CA10-1997
High School Diploma -
West Sacramento High School
West Sacramento, CA06-1992
Skills
- Customer service
- Data entry
- Problem solving
- Active listening
- Attention to detail
- Remote office availability
- Data entry accuracy
- Phone etiquette
- Teamwork
Timeline
Customer Service Advocate
Centene
12.2022 - Current
Residential Caregiver
Psynergy
07.2022 - 12.2022
Service Center Representative Lead
Fanueil/Covered CA
11.2020 - 07.2022
Service Center Representative
Fanueil/Covered CA
07.2019 - 11.2020
Resident Services Assistant
Atria Senior Living
05.2017 - 07.2019
Certificate - Medical Billing
Western Career College
High School Diploma -
West Sacramento High School
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