Andrew Carter
Mize,MS
Summary
Committed to ensuring customer satisfaction by providing exceptional service and unmatched support. Proficient in utilizing customer service best practices and adept at exploring different solutions to address customer needs effectively.
Overview
7
7
years of professional experience
Work History
Customer Service Representative
UnitedHealth Care
01.2022 - Current
- Exceeded KPI’s and awarded Employee of the Month
- Skilled in PDP, DSNP, MA
- Employer Group, and Peoples Health Plans
- Assist members via phone interactions for benefits and eligibility, billing and payments, authorizations for treatment and explanation of benefits
- Analyze and research members issues to identify resolutions and possible cause while documenting required information in appropriate systems
- Own problems through to resolution on behalf of the customer in real time of through comprehensive and timely follow-up with the member
- Review and incoming healthcare claims from members and providers by navigating multiple computer systems and platforms to verify the data/information necessary for processing
- Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures
- For example, claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates
- Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
- Build and maintain relationships with operational partners through cross functional collaboration
- Systems I know how to use or have used to do my job
- Maestro, CMS MARx, GPS, COSMOS Navigator, Genesys, Microsoft Office Teams, SharePoint, Claim Decoder, and Macro
Correctional Officer
Lauderdale County Jail
01.2021 - 01.2022
- Processed inmates when they brought them to the jail
- Transport inmates to other facilities
- Done head counts of inmates within a section
- Monitor inmate behavior and reported anything that seemed unusual to ensure safety and security
- Assisted other Officers with management of inmates and helped train new officers
- Manage confrontational situations as they arise
- Write regular reports of activities
Correctional Officer
Covington County Jail
01.2020 - 01.2021
- Processed inmates when they brought them to the jail
- Transport inmates to other facilities
- Monitor inmate behavior and reported anything that seemed unusual to ensure safety and security
- Assisted other Officers with management of inmates and helped train new officers
- Manage confrontational situations as they arise
- Write regular reports of activities
Business Owner
Lion Vapor LLC
01.2018 - 01.2020
- Ran day to day activities for the business
- By placing order for the shop or helping customers on anything they might have needed
- Done payrolls for all employees under my care
Education
High School Diploma -
Seminary High School
Seminary, MS05-2017
Skills
- Customer Service
- Active Listening
- Being Coachable
- Collaborating
- Communication & Influencing
- Growth Mindset
- Managing Conflict
- Resilience and Resourcefulness
- Self-Management
- Computer Proficiency
- Microsoft Office Suite
- Taking Initiative and Risks
Timeline
Customer Service Representative
UnitedHealth Care
01.2022 - Current
Correctional Officer
Lauderdale County Jail
01.2021 - 01.2022
Correctional Officer
Covington County Jail
01.2020 - 01.2021
Business Owner
Lion Vapor LLC
01.2018 - 01.2020
High School Diploma -
Seminary High School
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