Summary
Overview
Work History
Education
Skills
Timeline
Generic

Adriana Goodfellow

Buckeye,AZ

Summary

I'm a Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment.

Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.

Communicative customer service professional motivated to maintain customer satisfaction and contribute to company success.

History managing large amounts of inbound calls and sustaining satisfactory relationships with customers.

Offers skill with CRM systems paired with outstanding active listening and multitasking abilities. Personable and dedicated customer service representative with extensive experience in industry.

Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.

Reliable Customer Service Representative with extensive track record in demanding sales and account management environments. Strong presenter, communicator and problem solver working effectively and productively with diverse customers and individual needs.

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.

Overview

15
15
years of professional experience

Work History

Insurance Verification Specialist

Medicare- PPO
Tempe, AZ
04.2012 - 09.2019
  • Participated in training sessions on new software programs used for verification purposes.
  • Researched third party payer guidelines related to prior authorizations, coding and billing processes.
  • Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
  • Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
  • Ensured that the most current version of provider contracts were stored in the database.
  • Provided timely follow up with payers regarding payment status of claims.
  • Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
  • Assisted in resolving claim issues related to billing and reimbursement inquiries.
  • Interpreted Explanation of Benefits statements from various insurers and communicated relevant information with other departments as needed.
  • Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
  • Resolved insurance-related issues and discrepancies to prevent claim denials.

Credit Card Customer Service Representative

American Express
Tempe, Arizona
02.2005 - 05.2011
  • Addressed customer concerns in a timely and effective manner.
  • Implemented innovative methods for streamlining the customer service process.
  • Performed administrative tasks such as filing paperwork, updating databases and generating reports.
  • Answered customer inquiries and provided accurate information regarding products and services.
  • Resolved customer complaints promptly and efficiently.

Education

High School Diploma -

Corona Del Sol High School
Tempe, AZ
05-1998

Skills

  • Customer Service
  • Customer Relationship Management
  • Data Entry and Review
  • Insurance Coverage Verification
  • Coordination and Scheduling
  • Customer Database Systems
  • HIPAA Compliance
  • Insurance Billing
  • Coverage and Authorizations
  • Insurance plan verification
  • Patient Rapport
  • Communication and Interpersonal Skills

Timeline

Insurance Verification Specialist

Medicare- PPO
04.2012 - 09.2019

Credit Card Customer Service Representative

American Express
02.2005 - 05.2011

High School Diploma -

Corona Del Sol High School
Adriana Goodfellow