Cover;Resume

1. To whomit mayconcern,
I’ma verymotivated andfastlearnerwithskillsin the professionalfieldof customerservice.Inoticedin
your jobpostingthata big part of thispositionisinteractingwithcustomers.Duringmytime workingas
an on floorsupervisoratAonHewitt,Irealizedjusthow muchIenjoyedhelpingpeopleandensuring
that our clientswere well takencare.Inaddition,what reallysetsme apartfrom the othercandidates is
my abilitytobe a teamleaderwithprovenresults. Ialsoenjoyinteractingwithcustomersandknowthat
a happycustomeris a customerforlife.Iam excitedbythe prospectof bringingthissame levelof
commitmentandenthusiasmtothisnew andexcitingopportunity.Iknow that thispositionisagreat fit
for me and the company.
Bestregards,
FeliciaSaint-Jean

2. FELICIA SAINT-JEAN
931 S. Kirkman Road Orlando FL 32811 - Felicia.SaintJean1@gmail.com - 407.716.6762
PROFESSIONAL SUMMARY
 Professionalwith5+yearsof experience withpharmacybenefitsmanagement
 ProficientinMicrosoftOffice (Outlook,Word,Excel,PowerPoint,etc.)
 Business/financial acumen:Abilitytoapplycritical thinkingandadata-driven,analytical approach
to decision-makingandproblem-solving
 Strongcommunicationskills(verbalandwritten)–Workat home and Call center
 Reviewedall filedocumentationfor compliance withqualitystandards,accreditation
requirements,andall otherrelevantpolicies
 Abilitytointerpret medical abbreviations(SIGcodes)
 Abilitytoreview Third-PartyRejections, researchinformation,make corrections,andresubmit on
maintenance,specialty,narcotic,andothermedications
 Promptlyrespondedtogeneral inquiriesfrommembers,staff,andclientsviainstantmessage,e-
mail,andfax
PROFESSIONAL EXPERIENCE
Envolve Orlando, FL
03/21/2016-Current
 Receive andprocessincomingtelephonerequestsfrompharmacies,doctoroffices,member
service representativesandmembers
 Ensure that all customeraccountsare documentedandupdatedaccuratelyinthe database.
 Processoverridesforthe followingrequest:earlyrefills,vacation,lost,dose increaseandstolen
medication.
 Processclaimreversal due topharmacyerror
 Interviewcallertogatherinformationaboutthe problem(s)andleadthe callerthrougha
successful problemresolutioninreference topharmacybenefitclaims
 I assistnewandcurrent employeeswithsystemnavigation,andanyquestionsthattheymight
have while ona call.
Aon Hewitt Orlando, FL
On Floor Supervisor
01/2015-12/2015
 Coached,developedandperformance managedteam
 Performedtelephonicsupportforescalatedcalls
 Provideddirectsupporttostaff inregardsto verifyingand documentingneededsupportfor
insurance coverage
 Reviewedall filedocumentationforcompliance withqualitystandards,accreditation
requirementsandotherpolicies
 Assistedemployeeswithauthorization,denial andthe appeal process

3. Walgreens Orlando, FL
RegisteredPharmacy Technician
09/2011- 12/2014
 Primarily responsible for resolving third party rejects (TPRs)
 Responsible for reviewing the TPR, gathering information, making corrections, and resubmitting on
maintenance,specialty,narcotic,andothermedications
 Responsible for making telephone calls as necessary
 Responsible for following all guidelines and procedures for resolving third party insurance rejects
 Must be able to read and understand Walgreens prescription data entry guidelines and procedures;
applies and maintains appropriate licensure/registration, as required by stateregulations
 Must have the ability to interprets medical abbreviations (SIG codes)
 Answering inbound calls and voice mails from customers
 Promptlyrespondedtogeneral inquiriesfrommembers,staff,andclientsviainstantmessage,
e-mail,andfax
Optum, Orlando, FL
Pharmacy HelpDesk Rep
10/2009 - 11/2010
 Workedon CVSCaremarkaccount providingtelephone supporttopharmacistswithtechnical
issues andoverrides
 Successfullyresolvedmemberinquiries
 Analyzedsystemproblemsandquicklyarrivedataworkable solution
 Documentedandmaintainedrecordsusingstandardsystemsandprocedures
EDUCATION
 Healthcare Administration –A.A degree –projectedbyMay 2017
 WilliamT.DwyerHighSchool – Diploma
 HIPPA TrainedandQualified
 RegisteredPharmacyTech(CEcourses)