Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Anthony Simmons

Westerville,OH

Summary

Dedicated Customer Service Representative with a proven track record of delivering exemplary support and effectively resolving customer inquiries. Expertise in communication and problem-solving has consistently led to enhanced customer satisfaction and loyalty. Recognized for improving team performance through the sharing of best practices in customer service operations.

Overview

14
14
years of professional experience

Work History

Delivery Driver

Amazon
Etna, OH
12.2023 - Current
  • Managed daily routes, ensuring timely delivery of 180+ packages daily, maintaining a 98% on-time rate, and adhering to all safety regulations; resolved customer issues and provided excellent customer service on the spot.
  • Use handheld devices for routing information and customer delivery information.
  • Reduced fuel costs by 50% through effective route planning

Patient Service Representative-Hybrid Remote

Quantum Health
Dublin, OH
02.2022 - 12.2023
  • Investigated financial discrepancies and claim issues using CRM tools, performing root cause analysis to ensure accurate billing for members and clients.
  • Verified insurance coverage and obtained necessary authorizations for medical services, minimizing billing errors.
  • Engaged with patients to address concerns and resolve issues promptly and professionally, resulting in increased patient satisfaction ratings by 15%
  • Collaborated with healthcare providers to coordinate referrals for specialized treatments or consultations as required
  • Managed incoming/outgoing correspondence such as emails, faxes, mass mailings, and mail to ensure timely communication between patients and healthcare professionals
  • Achieved an average call resolution time of 9 minutes through practical problem-solving skills
  • Reduced billing errors by 65% through meticulous verification processes

Health Advocate-Full Remote

CVS Health
New Albany, OH
01.2020 - 01.2022
  • Engaged members as their single point of contact, utilizing CRM tools to explain benefits, rights, and responsibilities; addressed claim status, benefit coverage, eligibility, dental, vision, pharmacy, HSA, provider details, care management, onboarding, tool usage, and available programs/resources, incorporating medical terminology for clear communication
  • Own the members’ concerns through to resolution
  • Interacting with providers, clinicians, pharmacists, and many other professionals to provide total satisfaction and resolution to the member
  • Consistently build trusting relationships with members by understanding their needs and health aspirations
  • Deliver a suite of services to members that support easy navigation of the healthcare system, from providing personalized action recommendations to maintaining individual data accuracy and integrity
  • Maintained and/or exceeded performance metrics consistently
  • Collaborated with cross-functional teams to implement process improvements, resulting in increased patient satisfaction scores by 40%

Customer Service Advocate

United Healthcare
Westerville, OH
11.2015 - 12.2019
  • Consistently achieved first-call resolution for over 50 customer inquiries daily, addressing benefits, eligibility, claims, financial accounts, and correspondence, leveraging healthcare experience to achieve a 90% customer satisfaction rate.
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
  • Provide education and status on previously submitted pre-authorizations or pre-determination requests.
  • Participated in training sessions or workshops to stay updated on changes in Medicare billing rules and regulations
  • Collaborated cross-functionally with clinical teams to ensure accurate capture of billable services within established timelines
  • Assisted in training new staff members on Medicare billing processes, including coding guidelines and claim submission requirements
  • Managed denials and appeals process for denied Medicare claims, working closely with insurance companies to resolve outstanding issues
  • Maintained meticulous documentation of customer interactions, ensuring accurate records of inquiries, resolutions, and follow-up actions.

Specialist II Mortgage Services

JP Morgan Chase
Columbus, OH
08.2011 - 10.2015
  • Determined customer needs and provided appropriate solutions through relationship building
  • Responded promptly to customer inquiries regarding loan payments, escrow accounts, and other servicing-related matters
  • Assisted borrowers in completing necessary paperwork for loan modifications or refinancing options
  • Maintained accurate records of all communication with borrowers, including phone calls, emails, and written correspondence
  • Collaborated with loss mitigation team on identifying alternative solutions for borrowers facing financial hardship
  • Implemented software system for tracking and monitoring loan modifications, resulting in a 20% increase in efficiency
  • Investigated and resolved discrepancies related to escrow accounts including taxes, insurance premiums, etc

Education

Some College (No Degree) - Health sciences

Columbus State Community College
Columbus, OH

Skills

  • Communication skills
  • Proficient in Microsoft Word
  • Excel Proficiency
  • Conflict management
  • Persuasive Communication
  • Accountability in Tasks
  • First Call Resolution Expertise
  • Proactive Communication with External Contacts
  • CRM Application Experience
  • Proficient in Information Databases
  • Solution-Oriented Caller Support
  • Strong customer service skills
  • Knowledge to resolve questions and complaints for excellent customer care
  • Excellent with deadlines and time management

Accomplishments

· Bravo! Award for Quality for achieving 100% accuracy for first quarter 2017

· Bravo! Award for Performance received for 2017

· Bravo! Award for Compassion received for 2017

Timeline

Delivery Driver

Amazon
12.2023 - Current

Patient Service Representative-Hybrid Remote

Quantum Health
02.2022 - 12.2023

Health Advocate-Full Remote

CVS Health
01.2020 - 01.2022

Customer Service Advocate

United Healthcare
11.2015 - 12.2019

Specialist II Mortgage Services

JP Morgan Chase
08.2011 - 10.2015

Some College (No Degree) - Health sciences

Columbus State Community College

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Anthony Simmons