Knowledgeable and dedicated customer service professional with extensive experience in customer service industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Skills
Communications
Customer service
Team management
Complaint resolution
Medical terminology knowledge
Retro-Authorizations
Customer inquiries
Supervision
Problem resolution
Relationship development
Inbound and Outbound Calling
Account management
Basic medical terminology
Work History
03/2020 to Current
Clinical Operations RepresentativeNrg Energy, Inc. – Middletown, CT,
Input all patient data regarding claims and prior authorizations into system accurately..
Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Verified eligibility and compliance with authorization requirements for service providers.
Communicated pertinent information to client's prescribing provider to facilitate quality service.
Maintained patient confidentiality and safeguarded all medical records to avoid information breaches.
Escalated requests for non-standard services to correct department for review.
11/2018 to 03/2020
Customer Service RepresentativePanjiva – Virtual, UT,
Provided primary customer support to internal and external customers in fast-paced environment.
Answered customer telephone calls promptly to avoid on-hold wait times.
Worked effectively in fast-moving work environment to process large volumes of medical claims.
Followed up with insured individuals regarding premium and deductibles payments.
Evaluated all evidence with ultimate goal of creating positive outcomes for client's claims.
Used administrative guidelines as resource or to answer questions when processing medical claims.
Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
Maintained confidentiality of patient finances, records and health statuses.
Coordinated with contracting department to resolve payer issues.
11/2015 to 10/2018
Team LeadAlbertsons Company Inc. – Lincoln City, OR,
Tracked receipts, employee hours and inventory movements.
Documented counts and sorted finished work to promote easy access for shipping or additional processing.
Delivered superior training and leadership to teams to boost performance and help team members achieve performance targets.
Evaluated employee skills and knowledge regularly, providing hands-on training and mentoring to individuals with lagging skills.
Trained new hires by relaying information on company procedures, safety requirements and delivered constructive criticism upon completion of job tasks.
Established open and professional relationships with team members which helped resolve issues and conflicts quickly.
Reviewed and resolved differences between accounting information and cash drawer.
Restocked, arranged and organized merchandise in front lanes to drive product sales.
Processed POS transactions, including checks, cash and credit purchases or refunds.
Counted cash in register drawer at beginning and end of shift.
Used downtimes to prepare ingredients and restock supplies for expected busy periods.
Cleaned and sanitized dishes and utensils, consistently keeping adequate supplies on hand for expected customer loads.
Cooked batches of food according to standard recipes.
Communicated effectively with customers to plan large or specialized orders, providing customers with recommendations, samples and response to particular requests.
Greeted customers at deli counter to fulfill requests and answer questions.
11/2011 to 10/2018
Bakery ClerkPublix Super Markets – City, STATE,
Managed all baking operations professionally and handled all problems confidently.
Guaranteed all baked goods were cooked according to customers tastes and needs.
Verified functionality and code compliance of cooking equipment and utensils for optimal customer protection.
Inspected, checked and monitored baking products and supplies to guarantee freshness.
Enforced company safety, cleanliness and sanitation policies by maintaining effective housekeeping standards.
Processed POS transactions, including checks, cash and credit purchases or refunds.
Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers.
Checked identification for proof-of-age and refusing alcohol and tobacco sales to underage customers.
Offered immediate assistance and menu advice to guests, documented orders and conveyed special requests to baker and assistants.
Helped customers locate ideal menu items by listening to needs and recommending specific products or services.
Arranged bakery displays to showcase baked goods, cakes and pies to drive product sales.
Decorated and merchandised quality bakery goods to build business reputation and revenue base.
Assisted bakers with procuring necessary ingredients from inventory area during high-volume periods with demanding order levels.
Monitored counter and display inventory, replacing stock and requesting new product from kitchen to keep areas well-stocked for maximum sales.
Responded to customer requests for products, services and company information.
Education
Expected in 06/2014
High School Diploma: Apopka High School - Apopka, FL GPA:
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