Simera Professional Key (SPK)

Karol P

Guatemala

Level 2 Customer Service Advisor | Healthcare Insurance

$ 2,400/month

7 yrs exp

Healthcare Customer Service professional with 4 years of experience supporting U.S. health insurance members. Skilled in claims, billing, eligibility, enrollment, issue resolution, and escalated cases. Recognized for strong communication, problem-solving abilities, and leadership experience as a Subject Matter Expert and Temporary Supervisor. Passionate about delivering exceptional customer experiences and contributing to high-performing remote teams.

Skills

  • Customer Service
  • Documentation
  • Visual Communication
  • Google Workspace
  • Kustomer
  • Microsoft Office 365
  • Microsoft Office Suite
  • User Research
  • Communication
  • Team Collaboration
  • External Communications
  • Verbal Communication
  • Billing and Invoicing
  • Dispute Resolution
  • Customer service skills
  • costumer service
  • Custumer service 70%
  • Issue Resolution
  • Microsoft Office
  • Customer Service Rep
  • Customer Service Chat
  • Customer services
  • customer service,
  • Remote Collaboration
  • Google Workspace Suite
  • Remote Collaboration Tools
  • Remote Team Collaboration
  • Emotional communication
  • email communication
  • HIPAA Compliance
  • Googleworkspace
  • HR Compliance
  • Customer serve
  • Customer Escalation Handling
  • Client Issue Resolution
  • Escalation Handling
  • Document Automation
  • SOP Documentation
  • healthcare insurance
  • coustomer service
  • Remote Colaboration
  • Basic Microsoft Office
  • Insurance Operations
  • API Documentation
  • User Documentation
  • SaaS Documentation
  • Google Suite/Workspace
  • documentacion
  • Subject Matter Experts
  • Customer service
  • Billing / invoicing
  • Customer service emails
  • Remote work collaboration
  • customer service cu
  • Escalation handling
  • Legal Documentation
  • Customer.io
  • Inbound and Outbound operations
  • Curtomer Service
  • Custumer service 80%
  • Inbound & Outbound Sales
  • custumer services

Karol P

Guatemala

Level 2 Customer Service Advisor | Healthcare Insurance

$ 2,400 /month

Part Time: $ 1,450/month

7 yrs exp

Healthcare Customer Service professional with 4 years of experience supporting U.S. health insurance members. Skilled in claims, billing, eligibility, enrollment, issue resolution, and escalated cases. Recognized for strong communication, problem-solving abilities, and leadership experience as a Subject Matter Expert and Temporary Supervisor. Passionate about delivering exceptional customer experiences and contributing to high-performing remote teams.

Skills

  • Customer Service
  • Documentation
  • Visual Communication
  • Google Workspace
  • Kustomer
  • Microsoft Office 365
  • Microsoft Office Suite
  • User Research
  • Communication
  • Team Collaboration
  • External Communications
  • Verbal Communication
  • Billing and Invoicing
  • Dispute Resolution
  • Customer service skills
  • costumer service
  • Custumer service 70%
  • Issue Resolution
  • Microsoft Office
  • Customer Service Rep
  • Customer Service Chat
  • Customer services
  • customer service,
  • Remote Collaboration
  • Google Workspace Suite
  • Remote Collaboration Tools
  • Remote Team Collaboration
  • Emotional communication
  • email communication
  • HIPAA Compliance
  • Googleworkspace
  • HR Compliance
  • Customer serve
  • Customer Escalation Handling
  • Client Issue Resolution
  • Escalation Handling
  • Document Automation
  • SOP Documentation
  • healthcare insurance
  • coustomer service
  • Remote Colaboration
  • Basic Microsoft Office
  • Insurance Operations
  • API Documentation
  • User Documentation
  • SaaS Documentation
  • Google Suite/Workspace
  • documentacion
  • Subject Matter Experts
  • Customer service
  • Billing / invoicing
  • Customer service emails
  • Remote work collaboration
  • customer service cu
  • Escalation handling
  • Legal Documentation
  • Customer.io
  • Inbound and Outbound operations
  • Curtomer Service
  • Custumer service 80%
  • Inbound & Outbound Sales
  • custumer services

Level 2 Customer Service Advisor | Healthcare Insurance

Independence Blue Cross | Everise
October 2022 - September 2026

Assist members with questions related to billing, claims, benefits and eligibility, enrollment, and account information. Handle inbound and outbound calls, research account information, and work across multiple systems to resolve customer concerns. Handle escalated and complex cases, including supervisor calls, while documenting interactions and following the appropriate resolution process. Research member accounts and system information to investigate issues, identify discrepancies, and determine the appropriate next steps. Document customer interactions, findings, and actions taken while following company procedures and privacy requirements. Communicate internal issues and escalations through email, providing clear information for further investigation and follow-up. Worked as a Subject Matter Expert for approximately two years, assisting agents with process questions, complex cases, and system navigation. Supported refresher sessions and coaching activities on topics including First Contact Resolution (FCR) and Customer Satisfaction (CSAT). Completed a four-month Temporary Supervisor assignment, supporting team members and assisting with escalations and daily operational needs.

Level 3 Customer Service Advisor | Back Office Agent

Claro GT | Allied Global BPO
June 2019 - February 2022

Assisted customers with mobile service issues, account questions, billing concerns, and service-related problems. Reviewed customer accounts and invoices to identify discrepancies and report anomalies. Processed credits for minutes and mobile data for prepaid and postpaid plans according to established procedures. Provided support through inbound calls while reviewing account and service information to identify solutions. Worked in the Back Office department for approximately six months, following up on previously reported technical issues and providing updates until resolution. Tracked technical cases and customer requests, making sure reported issues received the necessary follow-up. Supported customer retention by addressing service concerns and finding appropriate solutions based on each customer's situation.

Customer Service Agent

Amazon | NCO Star Communication
October 2018 - June 2019

Assisted customers with questions about shipping costs, estimated delivery times, and shipment status. Coordinated with carriers to research shipping issues and provide customers with accurate updates. Handled customer concerns while maintaining service quality and supporting customer retention.

Smart Scores

Communication
88
Role Fit
95
Adaptability
82
Problem-solving
85

Smart Skills

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