Outright Immigration Services LLC/Outright Immigration Outreach Inc• Assisted individuals with preparing documents to obtain legal status in the U.S.• Provided translation services for immigration-related documents.• Offered mobile and remote online notarial services.• Solemnized marriages in the physical presence of both parties.• Guided individuals in finding GED preparation/testing and higher education facilities.• Assisted with applications for financial aid and student loans.• Delivered educational programs on behavioral health, nutrition, health, and finance for immigrants, refugees, and those in need.• Educated on professional skills, etiquette/attire, self-development, and self-growth.• Assisted with resume building, job search tools, and job placement.• Educated on finance and budgeting.• Provided food assistance to the less fortunate during holiday seasons.• Prepared and submitted immigration documents to USCIS and followed up on immigration cases.

Team Lead, Customer Service | 04/2023 - Present• Assist specialists in achieving departmental goals.• Collaborate with Management and Client Services to resolve phone inquiries related to claims adjudication, eligibility verification, prior authorization, and other pharmacy and ancillary benefits management functions.• Serve as a point of escalation for calls/emails to ensure timely resolution of customer issues.• Manage and allocate employee resources, including training, development, planning, and addressing complaints.• Coordinate with other departments to meet standards and goals.Clinical Specialist | 04/2022 - Present• Support Clinical Care Service Department during high season.• Conduct routine activities related to Independent Pharmacotherapy Evaluation.• Process and track Therapeutic Alert Letters.• Manage medical records requests, consultations, and scheduling.• Upload final documents, complete billing functions, and communicate with claims professionals, prescribers, injured workers, and attorneys.• Assist with recording and processing clinical recommendations and outcomes.Customer Service Specialist | 10/2017 - 04/2023• Resolve inquiries related to claims adjudication, eligibility verification, prior authorization, and pharmacy benefit management for workers' compensation.• Serve as the first point of contact for Ancillary Benefits Management and Billing Verification Department.• Enroll claimants in Home Delivery Service and follow up on prescription requests.

• Managed health, dental, vision insurance and life insurance.• Processed benefits enrollments, changes, and terminations accurately and timely.• Served as primary contact for benefits inquiries and issues.• Assisted with benefits enrollment and benefits education.• Maintained and updated benefits records and documentation.• Developed and distributed benefits materials and communications.• Resolved issues with benefits providers and escalated concerns as necessary.• Analyzed benefits data to identify trends and cost-saving opportunities.• Prepared reports on benefits utilization, costs, and participation.

• Provided a valuable connection between insurance customers and the policy providers. • Offered Life Insurance Plans, as well as Health Insurance Plans, Dental and Vision Plans.

• Monitored daily inbound/outbound call reports and team performance.• Updated team on weekly metrics and provided feedback to correct errors and improve performance.• Coordinated and conducted monthly team meetings.• Managed communications among customer care representatives, field service reps, members, case managers, and staff.• Created and emailed daily call reports to the Director and the MCO Team.• Created and updated training manuals for the team.• Trained customer service specialists and ensured adherence to quality standards and deadlines.• Developed a Customer Service Reward and Recognition program.• Processed MCO referrals, authorizations, and concerns, including expedited post-discharge referrals.• Assisted members, case managers, and management with their requests.• Handled escalated quality complaints and supervisor calls.• Distributed post-discharge referrals to team members and managed follow-up attempts.• Supported customer service and billing staff to provide resources for field service reps.• Assisted customers whose primary language is Spanish or Creole.• Provided support for special projects and center operations.

• Managed inbound customer service calls and emails for rental termination requests, equipment service requests, rental inquiries, billing issues, and escalations for Cash, National, and Government Accounts.• Escalated after-hours emergency service and rental requests following established procedures, utilizing branch contact information.• Provided on-the-spot coaching to ensure adherence to call standards, including proper greeting, closing, information gathering, surveys, and upselling techniques.• Supported quality assurance efforts and contributed to new hire development programs.• Assisted customers and corporate clients, including Spanish and French speakers, and instructors with registration, purchasing, enrollment, and class changes for United Academy products.• Processed credit card payments and checks over the phone for U.S. and Canadian customers.• Handled initial inquiries and requests for refunds, technical support, and general information about United Academy products.

Share benefit and eligibility information for UMR medical, dental, and short-term disability with members and providers. Assist in physician assignments to patients. Submit authorization requests for treatment services. Research billing and payment issues on claims. Process customer material requests and submit UMR Explanation of Benefits (EOB) to members and providers.Mentor new employees and create documentation for implemented processes.Perform translation services for the claim department on foreign claims and serve as Spanish, French and Haitian-Creole interpreter for the short term disability office.

Assist customers in reporting problems with diabetes testing products and ensure ticket updates conform to FDA requirements and guidelines. Determine problems with medical devices and order replacement for damaged medical devices for customers in the US territories and Canada. Participate in marketing upgrade promotions for the US and Canada.Quality Control by scrubbing product inquiry and sample request cases daily for accuracy.Monitor the Nova Customer Care voicemail and do follow-up calls. Assist in performing call monitoring for Answer Excellence customer service reps supporting 3rd shift. Provide translation services for customer scripting, marketing material and internal procedures.

Lead a live tutorial Spanish or French class with one on one or multiple students. Assist ESOL/ESL students with English essay by reviewing and offering suggestions for corrections, following the instructor’s guidelines. Answer questions submitted by the student through our online Q&A Center.Provide translation services for internal procedures and guidelines.

Resolve issues related to home and auto insurance claims, warranties, and benefits for Spanish and French-speaking customers in the US and Canada. Answer emergency roadside service calls; ensure safety and quickly dispatch assistance to the stranded motorist. Sales, renew, retain, and cancel service plan. Responsible for managing credit card transactions over the phone for membership enrollment and renewal. Process service claims for providers regarding home and auto lockout and towing services.Serve as a backup for account receivable clerk.

Negotiate terms of products with suppliers in Spanish and Haitian-Creole languages. Coordinate purchase with suppliers to achieve the best price/best quality and to ensure timely delivery. Expedite purchase orders by identifying and resolving shipment problems. Maintain records of supplier contracts, agreements, and goods ordered received. Make recommendations and advise senior management on all purchasing issues. Create the logo for the company to stamp on the water plastic bags. Transport goods for the business from the Dominican Republic to Haiti as needed.Products: Plastic Sheeting Roll - Accessories and parts for Plastic Sealing Machine - Filters and Membranes - Water Softeners - Test Strips.

Oversee and coordinate purchasing activities including supplier selection, contracts, quality and cost control, and receiving of goods. Travel out of the country to purchase industrial equipment and order machinery parts and equipments such as chain hoist, air compressor and generator.

Assist students and teachers on preparing homework, exams, thesis among others. Translate documents in English, French, Spanish and Haitian-Creole and vice-versa. Assist customers when they have trouble or questions using computer software such as Microsoft Office, Adobe and other softwares that are being used in the cyber cafe. Provide excellent customer care and services such as scanning, printing and downloading. Maintain cleanliness and orderliness of the place. Keep accurate record of logs and inventories of the shop. Time customers when they use the computer or internet.

Enroll, maintain, retain and cancel accounts for AT&T calling cards, domestic, long distance and international phone plan for US and Snowbirds customers in Spanish, French and Haitian-Creole. Perform billing investigations and adjustments for residential accounts. Perform filing, data management, drafting and editing short office memos.Handle escalation calls in the absence of the supervisor.Provide training to new employees and internal clients on products and continuing education on procedural changes to team members.