Angelica Allen
Summary
Efficient and detailed-oriented associate with 5+ years of customer service experience. Highly adaptable and committed to maintain customer satisfaction and contribute to the company's success. Knowledgeable about application requirements for private insurance plans and committed to providing detailed and accurate work with exemplary critical thinking and decision making skills.
Overview
5
5
years of professional experience
Work History
CSR Dental Representative
CVS Health
06.2022 - 07.2023
- Coordinated with dental providers to obtain payments and resolve issues.
- Review emerging dental trends, network management, claims policy, and standards of care.
- Determine if both State and Federal regulatory requirements are met to enroll in Aetna provider insurance.
- Review supporting documentation for adequacy; Make final determination on claim.
- Research and respond to specific dental claims via written and verbal inquiries.
- Reviewed internal database for predetermination and claim determination reviews.
- Educated providers on company systems, form completion, and access to services.
CSR Dental Representative
CVS Health
07.2023 - Current
- Coordinated with dental providers to obtain payments and resolve issues.
- Review emerging dental trends, network management, claims policy, and standards of care.
- Determine if both State and Federal regulatory requirements are met to enroll in Aetna provider insurance.
- Review supporting documentation for adequacy; Make final determination on claim.
- Research and respond to specific dental claims via written and verbal inquiries.
- Reviewed internal database for predetermination and claim determination reviews.
- Educated providers on company systems, form completion, and access to services.
Customer Service Associate
IRS
02.2020 - 07.2021
- Utilized internal software and tools to meet customer needs and resolved issues promptly
- Trained new personnel regarding company operations, policies and services.
- Handled billing and payment issues following guidelines, resolving disputes properly.
- Answered over 120 calls per shift to meet department quota.
- Resolved complaints to satisfy customers and encourage future transactions.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Reviewed and solved account and billing discrepancies.
- Navigated multiple computer systems and applications to find information.
- Communicated with clients regarding account services, statements, and balances.
Patient Care Advocate
Express Scripts
06.2019 - 01.2020
- Used non-scripted probing techniques to determine needs and offered most appropriate product or services
- Resolved problems with areas such as communication and billing that could negatively impact enrollment.
- Maintained confidentiality of patient data and condition to safeguard health information.
- Facilitated communication between patients, families and healthcare providers to support comprehension.
- Responded to patient concerns and questions with compassionate and knowledgeable service.
- Worked effectively with staff from all departments to coordinate resolutions.
Data Entry
Allstate
08.2018 - 02.2019
- Produced monthly reports using advanced Excel spreadsheet functions.
- Managed documents by organizing forms, making photocopies, filing records, preparing correspondence, and creating reports.
- Coded and processed applications into required electronic formats.
- Organized, sorted, and checked input data against original documents.
- Entered data into various computer systems accurately.
- Verified accuracy of data entered into system to produce error-free reports.
Education
Diploma -
William M. Raines
06.2016
Skills
- Goal Oriented
- Detail Oriented
- Project Management
- Conflict Resolution
- Exceptional Verbal, Written, and Interpersonal
- Data Entry
- Critical Thinking and Decision Making
- Record Maintenance Skills
- HIPAA Compliance
- Documentation and Reporting
- Database Research
Timeline
CSR Dental Representative
CVS Health
07.2023 - Current
CSR Dental Representative
CVS Health
06.2022 - 07.2023
Customer Service Associate
IRS
02.2020 - 07.2021
Patient Care Advocate
Express Scripts
06.2019 - 01.2020
Data Entry
Allstate
08.2018 - 02.2019
Diploma -
William M. Raines