Alexandra e Cruz
Customer Service Agent @Aetna, A Cvs Health Company
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WORK HISTORY
Customer Service Agent @Aetna, A Cvs Health Company
Handle inbound inquiries from Medicaid members, providers, and plan sponsors via phone, email, or letters.Respond to questions about eligibility, benefits coverage, provider network, and ID cards.Document and track each interaction accurately using internal systems; maintain notes and follow-up tasks.Triage complex cases and escalate appropriately (e.g, provider billing issues, complaints, grievances, appeals).Assist with claims referrals, pre-authorizations, complaints, and appeals, ensuring member issues are resolved or transferred properly.Educate members on their rights and responsibilities, plan benefits, and self-service tools, anticipating needs before they arise.Use a customer service threshold framework to make financial decisions when resolving member issues.Build emotional rapport, fostering trust by actively listening and showing empathy to members in potentially challenging situations.Utilize multiple internal tools and systems to provide timely, accurate responses. Technical skills and attention to detail are critical.
EDUCATION
Thinkful
Certificate
Miami Dade College
Bachelor of Education - BEd
Miami Dade College
Associate of Science - AS
ABOUT ALEXANDRA E CRUZ
Excited to share that I\'ve just completed my Cybersecurity Certification from Coursera! This journey has been incredibly rewarding and eye-opening. Through the course, I gained a solid understanding of various cybersecurity concepts and tools, including threat analysis, risk management, and network security. I also honed my skills in identifying vulnerabilities, protecting sensitive data, and responding to security incidents effectively.As a Security Analyst, I learned how to:Analyze security systems to identify and mitigate risksImplement robust security measures to protect against cyber threatsMonitor network traffic for suspicious activitiesConduct thorough vulnerability assessments and penetration testingDevelop and enforce security policies and proceduresI\'m thrilled to bring my newfound knowledge and skills into the world of cybersecurity. With the rapid pace of technological advancements and the ever-evolving threat landscape, I am eager to contribute to creating safer digital environments.If you or your organization is looking for a passionate and dedicated cybersecurity professional, let\'s connect! I\'m ready to tackle new challenges and help safeguard your digital assets.
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