Versatile Customer Service Representative - Resume Example

2021-07-02 04:45:29
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Sewanee University of the South
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Resume
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Versatile customer service representative with motivation to maintain customer satisfaction and contribute to the companys success. I am confident that my qualifications will become an asset to my future employer.

Education

Valencia College, Kissimmee, Florida Associate of Arts Degree, August 2017

Major: General Studies in Progress

Coursework in Medical Terminology and Interpersonal Communication

Governor Thomas Johnson, Fredrick, Maryland High School Diploma, June 2003

Work Experience

KForceStaffing, Orlando, Florida November 2016 - July 2017

Pharmacy Helpdesk Representative

Effectively resolved insurance rejections and other billing issues.

Performed technical processes required to dispense medications to patients.

Completed new and updated patient profiles, including lists of patient medications.

Analyzed call volume and average call time to monitor Customer Service Representative performance and productivity

Walgreens, Orlando, Florida August 2015 January 2016

Customer Care Advisor

Scheduled take care and DR walk in healthcare clinic appointments based on availability for new and existing patients.

Verified patients' insurance coverage and provided pricing on preventative, treatment, and wellness services.

Utilized all available information to choose the best solution and resolve customer concerns.

Answered an average of 100 calls per day by addressing customer inquiries, solving problems and providing new product information.

Maintained long-term customer relationships and advised customers on purchases and promotions.

AcariaHealth Specialty Pharmacy, Orlando, Florida August 2014 June 2015

Insurance Verification Coordinator (Prior Authorisation)

Investigated prescription benefits and completed benefit verification on behalf of the patient.

Collaborated with doctors' offices and insurance payers regarding the outcomes of clinical prior authorizations submissions.

Familiarity of CPT and ICD 9 & 10 coding of medications and diagnosis.

Knowledge of various medical conditions including Growth hormone deficiencies , Diabetes, Cancer, Multiple Sclerosis, Rheumatoid Arthritis, and Hepatitis .

Initiated the prior authorization process for continued therapy coverage on specialty prescriptions.

Wal-mart Health Services, Orlando, Florida February 2014 August 2014

Patient Care Coordinator

Provided customer service to pharmacy patients by responding to customer calls and emails using Wal-Mart systems, training, and manual to resolve customer and associate inquiries.

Maintaining confidentiality of patient health information; processing and submitting call requests for refills, transfers, payments, new prescription requests, pricing for medications.

Identifying and resolving discrepancies for customers orders and researching customer billing issues.

Assisted the pharmacists with checking in and pricing drug orders, third party transactions and relevant paperwork.

Communicated regularly with physicians, nurses, insurance companies and managed care organizations.

Saved patients money and increased pharmacy profit margins with therapeutically equivalent and more cost-effective generic drugs.

Express Scripts, Orlando, Florida December 2012 February 2014

Patient Care Advocate

Handled customer service inquiries in a fast paced call center from members, providers, physicians and internal and external clients related to pharmacy benefits.

Leadership role involving distribution of logistics to other patient advocates on my team.

Displayed patient-oriented and comprehensive clinical pharmacy services and pharmaceutical care.

Science Applications International Corporation, Rockville, Maryland March 2011-May 2011

Call center Generalist Contractor

Data entry and problem solving on reporting government pre- award applications.

Manage and track and upkeep of complex excel access and Remedy records.

Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.

Improved call center functionality and service capacity by resolving customer complaints efficiently and quickly.

Randstand Staffing, Rockville, Maryland October 2010 August 2012

Customer Service Contractor

Medical Records Payroll Clerk- Initiated and updated payments with invoice numbers using Excel spreadsheets. Generated and printed appropriate reports and documents to aid in analysis of completed payment for medical records.

Researched payment amounts and invoice numbers for patients through the database called PHI-and IT.

Human Resources Clerk / Receptionist - Successfully and consistently facilitated the recruitment and hiring process by completing employment verification and research as needed.

Maintained a coherent and efficient office environment by implementing and adhering to office processes such as faxing, scanning and filing confidential documents and records.

Verified employment status and other HR related activities using various human resources software such as Human Resources Management System.

Provided reception desk coverage on an as needed basis.

Administrative Clerk- Performed product research, data entry focusing in complex excel spreadsheets, electronic maintenance and upkeep of records and documents, triage for email, fax and voice communications between the client and members of the organization, and ensuring communication followed company compliance with security procedures consistent with government contracting standards.

Professional Skills

Medical terminology understanding

Familiarity with Key Performance Indicators (KPIs)

Exceptional workflow management

Team building expertise

Types 35WPM

Prior Authorization training

Dedicated team player

Strong problem solving aptitude

Specialty Pharmacy knowledge

Motivated self-starter

Superior verbal and written communication skills

Analytical thinker

Team leadership skills

Professional Certification

Certified Nursing Assistant (Advanced) Insert Year

 

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