Filomeno Tavares
Boston
Summary
Dedicated Member Representative motivated to maintain customer satisfaction and contribute to company
success. More than 5 years of experience in healthcare as a Senior Member Service Representative.
Overview
13
13
years of professional experience
Work History
Customer Service Representative
Eversource Energy
03.2023 - Current
- Answer high volume of calls within call center environment.
- Listen attentively to caller needs to ensure a positive customer experience.
- Handle customer inquiries, complaints, billing questions and payment extension/service requests.
- Assisted customers regarding high gas and electric bill in respect to previous meter read, current read, and kilowatt per hour usage.
- Recommended ways to save on energy thru mass save, budget billing, discount rate, energy saving tips and alternate suppliers.
- Accepted assignments with open, cooperative, positive, and team-oriented attitude.
- Participated in walk in my shoes program to shadow the meter department.
- mentored new hires.
Senior Member Service Representative
Tufts Health Plan
09.2015 - 03.2023
- Answered high influx of inbound calls within dynamic call center environment.
- Ensured that customer inquires are resolved at first point of contact.
- Checked status for referrals, authorizations and confirmed paid and unpaid hospital/medical claims.
- Assisted members with primary care physician selections, pharmacy, appeals, grievances and plan benefits inquiries.
- Demonstrated knowledge of HIPPA Privacy and Security Regulations by appropriately handling member information.
- Outreached members to welcome them into tufts health plan and performed other duties assigned by management.
Member Service Representative
MassHealth
10.2011 - 10.2014
- Provided service to members in fast paced environment.
- Review electronic documents, financial, and background data for member eligibility updates.
- Helped members complete medical benefit application and eligibility review form.
- Resolved escalated issues efficient and timely manner.
- Educated callers on eligibility, appeal rights, program guidelines, and health plan options.
Education
High School Diploma -
East Boston High School
Boston, MA08.2006
Skills
- Fluent in Cape Verdean Creole and English
- Excellent communication skills and courteous
demeanor - Researched, calmed and rapidly resolved client
conflicts
- Received awards for quality calls
- Highly professional, dependable, reliable and able to perform duties with minimal supervision
- Mentored new hires
Timeline
Customer Service Representative
Eversource Energy
03.2023 - Current
Senior Member Service Representative
Tufts Health Plan
09.2015 - 03.2023
Member Service Representative
MassHealth
10.2011 - 10.2014
High School Diploma -
East Boston High School
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