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Customer Service Representative Resume Example

Resume Score: 80%

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MG
CUSTOMER SERVICE REPRESENTATIVE
Professional Summary

Hardworking individual bringing 20 years of experience meeting customer needs via telecommuting roles. Skilled in listening to customers, meeting productivity targets and maintaining current knowledge of company offerings. Offering empathy, reliability and enthusiasm for satisfying customers.

Work History
Company Name - Customer Service RepresentativeCity, State12/2019 - Current
  • Compiled customer feedback and recommended service delivery improvements to management.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Responded to customer requests for products, services and company information.
  • Used company troubleshooting resolution tree to evaluate technical problems while leveraging personal expertise to find appropriate solutions.
  • Educated customers on promotions to enhance sales.
  • Boosted sales revenue by skillfully promoting diverse winter sport options.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Achieved and consistently exceeded revenue quota through product and service promotion during routine calls.
  • Liaised with customers, management and sales team to better understand customer needs and recommend appropriate solutions.
  • Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Company Name - Lead Biller/DispatcherCity, State09/2004 - 12/2018
  • Maintained accuracy, completeness and security for medical records and health information.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Interacted and communicated easily with department personnel and public.
  • Communicated effectively with staff, patients and insurance companies by email and telephone.
  • Kept accurate log of all requests for medical information and records.
  • Utilized web sites to manage and confirm patient data, such as insurance, demographic and medical history information.
  • Completed clerical tasks such as filing, copying and distributing mail.
  • Developed team communications and information for staff meetings.
  • Assisted manager with claims, appeals, authorizations and ther managerial responsibilities.
  • Handled contracts with insurance companies and local towns
  • EMD certified to take 911 calls
  • HIPPA
Company Name - Medical BillerCity, State09/2001 - 09/2004
  • Analyzed medical records to satisfy insurance company mandates.
  • Oversaw all billing for Medicaid PCA, waiver and skilled claims, commercial insurance and private pay clients.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Set up and maintained new electronic billing system.
  • Analyzed complex Explanation of Benefits forms to ensure insurance carriers were charged correctly.
  • Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Translated and interpreted medical billing codes with strong accuracy to ensure swift payment from insurance agencies.
  • Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
  • Reviewed patient diagnosis codes to ensure accuracy and completeness.
  • Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
  • Efficiently collected payments and communicated with clients.
  • Communicated with insurance providers to ensure any denied claims were resolved and resubmitted.
  • Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
  • Verified proper ICD-9 coding on claims.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Collected payments and applied to patient accounts.
  • Assisted patients by determining financial assistance available and setting up payment plans.
  • Prepared billing statements for patients and ensured correct diagnostic coding.
  • Orchestrated day-to-day operations of billing department, including medical coding, payment posting, accounts receivables and collections.
  • Ensured proper submission of workers comp and MVA claims.
  • Reviewed patient records, identified medical codes and created invoices for billing purposes.
  • Filed and updated patient information and medical records.
  • Reviewed outgoing bills for eligibility and accurateness.
  • Transferred balances to correct payers.
  • Devised new methods to make workflows more efficient and brought suggestions to attention of the manager
  • Maintained current accounts through aged revenue reporting.
  • Posted payments and collections on regular basis.
  • Researched and followed up on denied insurance claims.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Followed up on legal claims.
  • Gathered information from multiple sources to simplify billing and organize accounts.
Company Name - Manager/Head WaitressCity, State09/1996 - 09/2001
  • Trained and guided team members to maintain high productivity and performance metrics.
  • Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows to meet any daily demand.
  • Set and managed schedules to give proper coverage to required areas and meet customer service demands.
  • Interviewed and hired strong candidates for team openings, using newspapers, job boards and social media to find applicants.
  • Trained new employees in specific job requirements.
Skills
  • Client records management
  • Client advocacy
  • Community Resources
  • Individual and group counseling
  • Case Management
  • Conflict resolution
  • Data Analysis
  • Data Collection
  • Database Management
  • Customer Service
  • MS Office
  • Team building
  • Time management
  • Operational Improvement
  • Budgeting
  • Quality Assurance
  • Inventory Management
  • Training
  • Data Entry
  • Strategic Planning
  • Cash Management
  • Administrative support
  • Research
  • Documentation
  • Project Management
Education
University of Massachusetts AmherstCity, StateSome College (No Degree): Sports Management
06/1993Mohawk Trail Regional High SchoolCity, StateHigh School Diploma
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Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

Resume Overview

School Attended

  • University of Massachusetts Amherst
  • Mohawk Trail Regional High School

Job Titles Held:

  • Customer Service Representative
  • Lead Biller/Dispatcher
  • Medical Biller
  • Manager/Head Waitress

Degrees

  • Some College (No Degree) : Sports Management
    High School Diploma

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