Amber Dickson
Fresno,CA
Summary
Call Center Representative versed in customer support in high call volume environments. Superior computer skills and telephone etiquette. Excellent communicator with 10 years in a demanding call center environment as a Customer Service Representative. I am ready to start my new career as a pharmacy technician. Capable pharmacy team member proficient in assisting pharmacists with preparing prescriptions and meeting customer needs. Safety-oriented and well-organized with solid experience coordinating with insurance providers, prescribers and individuals to address issues. Good relationship-building and multitasking skills.
Overview
11
11
years of professional experience
Work History
Customer Service Representative/ Adjudicator (Remote)
AppleOne-Assigned at Maximus
03.2022 - 05.2023
- Analyzing claim information to determine the cause of outstanding issues and daily data entry
- Assessing eligibility requirements based on UI Code, Policies, and Procedures
- Evaluating wage and earnings
- Communicating with claimants and employers by phone to obtain missing information
- Working closely with subject matter experts to gain further understanding of unique issues and how to address them
- Referring more complex issues to supervisor or tenured staff.
Customer Service Representative/ Case Initiation (Remote)
Insight Global
11.2022 - 04.2023
- Worked for CDC (Centers for Disease Control and Prevention) client
- Contacted individuals using a structured script
- Completed VAERS report form over the phone with individual
- Follow-up on voice mail messages left and receive incoming call-backs
- Document status of activities in the system received for accuracy and completeness
- Accurately complete tracking information using system interface and daily data entry
- Completed tasks per designated deadlines.
Customer Service/ At Your Service
Macy's
10.2022 - 04.2023
- Responsible for providing a great customer experience during all At Your Service activities including Buy Online Pickup in Store transactions, ringing and processing return merchandise, handling non-congruent items and performing other assigned duties in accordance with procedures and standards.
HR Assistant (Remote)
Amazon
01.2022 - 04.2022
- Serve as the support contact for employees with questions about their time away from work due to illness
- Take ownership of employee contacts ensuring that each contact is accepted and resolved with a high degree of customer focus
- Build customer trust by empathetic handling of sensitive issues
- Resolve queries by referring to documentation such as frequently asked questions and standard operating procedures and escalate when these cannot be resolved
- Receive queries via phone or web case and log contacts into the shared service case management system
- Handle customer absence claims end to end and contact customers to inform them of resolution, when appropriate
- Assess new claims and make accurate classifications about the type of absence required
- Contact employees as needed and keep them updated on the status of their claim
- Ensure all tasks and decisions are rendered within SLA
- Navigate ambiguous claim requests and apply good judgement about how to apply policy and regulations to the case in question
- Basic Qualifications and daily data entry.
Customer Service Representative/ IQA (Remote)
Aetna/CVS Company
10.2020 - 11.2021
- Supported comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs
- Promotes/supports quality effectiveness of Healthcare Services
- Performed intake of calls from members or providers regarding services via telephone, fax, EDI
- Utilized eTUMS and other Aetna system to build, research and enter member information
- Screens requests for appropriate referral to medical services staff
- Approved services that do not require a medical review in accordance with the benefit plan and daily data entry
- Performs non-medical research including eligibility verification, COB, and benefits verification
- Maintained accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
- Promoted communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third-party payers as well as member, family, and health care team members respectively) Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- Placed outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations
- Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria
- Communicated with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program
- Sedentary work involving significant periods of sitting, talking, hearing and keying
- Work requires visual acuity to perform close inspection of written and computer-generated documents as well as a PC monitor.
Office Operations Supervisor
U.S. Census Bureau
01.2020 - 06.2020
- Supervised 14 census clerks
- Conducted interviews and hiring process (Onboarding paperwork, fingerprints, etc.)
- Reviewed and approve daily payrolls
- Daily data entry
- Conducted quality assurance operations in the field
- Set up weekly hiring events
- Used Microsoft, excel, and skype programs daily.
Pharmacy Benefits Manager
Office Team
03.2013 - 04.2019
- Worked for client Envolve Pharmacy Solutions
- Responsible for fielding 115 calls per day, answering policy questions, explained changes, entered client information, assessed issues with plans and resolved pharmacy inquiries
- Effectively managed a high-volume of inbound and outbound customer calls, answered and daily data entry
- Multi-line phone and processed high volume of order requests from nurses, doctors and pharmacists
- Mastery of customer service management systems and databases
- Accurately documented, researched and resolved customer service issues
- Gathered and verified all required customer information for tracking purposes
- Directed calls to appropriate individuals and departments
- Defused volatile customer situations calmly and courteously
- Effectively controlled the release of proprietary and confidential information for general client lists.
Mail Clerk
Internal Revenue Service
01.2015 - 06.2015
- Analyzing claim information to determine the cause of outstanding issues
- Assessing eligibility requirements based on UI Code, Policies, and Procedures
- Evaluating wage and earnings
- Communicating with claimants and employers by phone to obtain missing information
- Working closely with subject matter experts to gain further understanding of unique issues and how to address them
- Referring more complex issues to supervisor or tenured staff
Customer Service Representative
Verizon Wireless
03.2012 - 03.2013
- Worked for Client Verizon Wireless
- Answers up to 90 calls daily and daily data entry
- Provided accurate and appropriate information in response to customer inquiries
- Always maintained up-to-date records
- Acted professionally and patiently when addressing negative customer feedback
- Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment
- Demonstrated mastery of customer service call script within specified timeframes
- Mastery of customer service management systems and databases.
Education
Certification - Pharmacy Technician
Fresno City College
Fresno, CA12.2023
High School Diploma -
Central Learning Adult School Site
Fresno, CA06.2011
Skills
- Customer Service
- Intake
- Microsoft Software
- Communication
- Behavioral Health
- Account Analysis
- Pharmacy
- Recruiting
- Help Desk
- Appointment Scheduling
- Account Updating
- Paperwork Processing
- Call Management
- Data Entry
- Microsoft Outlook
- Research
- Retail Store Support
- Technical Support
- Team Development
- Call Center Operations
- Document Control
- Customer Relationship Management (CRM)
- Computer Proficiency
- Quality Control
- Stock Management
- Quality Assurance Controls
- Customer Relations
- Account Management
- Spreadsheets
- Report Preparation
- Order Fulfillment
- Microsoft Excel
- Administrative Support
- Scheduling
- Data Collection
Timeline
Customer Service Representative/ Case Initiation (Remote)
Insight Global
11.2022 - 04.2023
Customer Service/ At Your Service
Macy's
10.2022 - 04.2023
Customer Service Representative/ Adjudicator (Remote)
AppleOne-Assigned at Maximus
03.2022 - 05.2023
HR Assistant (Remote)
Amazon
01.2022 - 04.2022
Customer Service Representative/ IQA (Remote)
Aetna/CVS Company
10.2020 - 11.2021
Office Operations Supervisor
U.S. Census Bureau
01.2020 - 06.2020
Mail Clerk
Internal Revenue Service
01.2015 - 06.2015
Pharmacy Benefits Manager
Office Team
03.2013 - 04.2019
Customer Service Representative
Verizon Wireless
03.2012 - 03.2013
Certification - Pharmacy Technician
Fresno City College
High School Diploma -
Central Learning Adult School Site