April Pam
Bogalusa,LA
Summary
Passionate and professional Representative leads outreach efforts, strategic direction and day-to-day function management. Proven talent at building relationships and influencing others to gain support and commitment. Excellent presentation and communication skills and comfort working in fast-paced environment.
Go-getter Representative works closely with business development professionals to meet objectives and achieve revenue goals. Engages consumers and business leads to educate in products and services offered. Generates new business opportunities using proven processes to prospect business leads and close new accounts.
Results-driven Representative known for productivity and efficiently completing tasks. Skilled in client communication, problem resolution, and process optimization. Excel in negotiation, strategy development, and customer relationship management. Leverage active listening, empathy, and persuasive speaking to achieve objectives and exceed goals.
Highly skilled Representative with experience in sales, customer service, and account management. Strengths include relationship building, problem-solving ability, and effective communication skills. Previous work has resulted in improved client relationships, increased revenue, and successful conflict resolution.
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.
Overview
10
10
years of professional experience
2003
2003
years of post-secondary education
Work History
Medicare Tier 2 Representative
Capitol Bridge Health Services
Bogalusa, LA
06.2025 - Current
- Assisted co-workers during busy periods or whenever needed in order to provide excellent customer service.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Resolved customer complaints in a professional manner while remaining empathetic to their concerns.
- Answered phone calls and directed them to appropriate personnel.
- Demonstrated strong problem solving skills when faced with challenging situations or complex inquiries from customers.
- Demonstrated exceptional service skills by going above and beyond to satisfy customers on phone and in person.
- Provided customer service by answering product and service related questions.
- Greeted customers and responded to inquiries in a timely manner.
- Utilized CRM software to track customer interactions, sales, and progress towards targets.
- Participated in regular team meetings to discuss performance, strategies, and goals.
- Escalated unresolved issues to appropriate departments for further investigation.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Increased customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
Medicare A/B Claims Representative
Capitol Bridge Health Services
Bogalusa, LA
04.2024 - Current
- Processed Medicare A and B claims efficiently, ensuring compliance with all regulatory requirements and reducing errors.
- Collaborated with healthcare providers to gather necessary documentation, streamlining claims submissions and enhancing approval rates.
- Utilized claims processing software to track and manage claim status, improving response times to inquiries from beneficiaries.
- Communicated with beneficiaries regarding claim statuses, clarifying coverage details and addressing concerns to promote customer satisfaction.
- Assisted in resolving claim discrepancies by conducting thorough investigations, contributing to accurate and timely payments.
- Participated in team meetings to discuss workflow improvements, fostering a collaborative environment focused on operational excellence.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Documented changes in claim statuses using specialized software systems.
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Resolved complex discrepancies in policyholder files to facilitate accurate claim processing.
- Conducted research into medical terminology related to healthcare claims processing activities.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
Medicare Customer Service Representative
Maximus Federal
Bogalusa, LA
06.2022 - 04.2024
- Assisted customers with Medicare inquiries, providing accurate information to enhance understanding of benefits and services.
- Processed customer requests efficiently, ensuring timely resolution and maintaining compliance with federal regulations.
- Educated beneficiaries on Medicare plans, fostering informed decision-making and improving overall client satisfaction.
- Collaborated with team members to streamline communication processes, enhancing service delivery and operational efficiency.
- Resolved complex customer issues by employing problem-solving skills, resulting in improved client retention rates.
- Maintained detailed records of customer interactions, ensuring data integrity and facilitating effective follow-up on inquiries.
- Monitored changes in Medicare policies, adapting service approaches to maintain compliance and uphold service quality.
- Answered incoming calls from Medicare beneficiaries, providing them with information regarding their benefits.
- Resolved customer complaints and concerns in a timely manner.
- Responded promptly to customer inquiries about coverage options, claims status, and other related topics.
- Processed enrollments for new Medicare members according to established procedures and guidelines.
- Participated in team meetings to discuss best practices for responding to customer inquiries.
- Provided guidance and support to customers regarding billing issues and payment plans.
- Provided technical assistance when necessary by troubleshooting any problems with online accounts or applications.
- Assisted customers in navigating the Medicare website, helping them to find the resources they needed.
- Delivered patient information, appointment results and insurance information to other office staff for reporting and billing purposes.
- Submitted reports on customer feedback trends and performance metrics.
- Monitored changes in regulations affecting Medicare services provided.
- Identified potential fraud cases involving Medicare beneficiaries.
- Analyzed customer feedback data to identify areas of improvement in service delivery.
- Developed training materials for new Customer Service Representatives.
- Responded to member questions regarding plan benefits and provisions.
- Handled new enrollments by entering customers' data and reviewing information.
- Provided beneficiaries with information about plan benefits and eligibility determinations.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Customer Service Representative
General Dynamics
Bogalusa, LA
12.2016 - 03.2021
- Provided exceptional customer support by resolving inquiries swiftly, enhancing client satisfaction and loyalty.
- Assisted in training new team members on operational procedures, promoting efficiency and knowledge sharing.
- Managed customer feedback effectively, leading to improved service protocols and increased positive interactions.
- Utilized CRM software to track customer interactions, ensuring accurate records and streamlined communications.
- Led initiatives to enhance team performance and customer engagement, fostering a culture of continuous improvement.
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Developed strong relationships with customers by providing personalized assistance and support.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Identified areas of improvement in customer service processes and suggested changes accordingly.
- Developed positive relationships with customers through friendly interactions.
- Provided exceptional customer service to ensure customer satisfaction.
- Resolved customer complaints promptly and efficiently.
Lead Sales Associate
Dollar General
Bogalusa, LA
02.2016 - 12.2016
- Provided exceptional customer service by addressing inquiries and resolving issues, resulting in increased customer satisfaction and loyalty.
- Led a team of sales associates, enhancing training programs to improve performance and elevate sales standards.
- Implemented organized stock management processes, ensuring product availability and optimal store presentation for customers.
- Conducted regular inventory audits, maintaining accurate stock levels and minimizing discrepancies through effective management practices.
- Assisted customers with product selections and recommendations, fostering a welcoming shopping environment that encouraged repeat visits.
- Collaborated with team members to achieve sales targets and execute promotional strategies, driving store profitability and growth.
- Mentored new associates on best practices in customer engagement and sales techniques, enhancing overall team performance.
- Monitored store operations and provided feedback to improve workflows, resulting in more efficient service delivery and customer experience.
- Assisted with the training of new sales associates.
- Received shipments, signed off on packages and documented incoming items in computer system.
- Provided customer service to ensure satisfaction.
- Supervised a team of sales associates on daily tasks and operations.
- Greeted customers and provided product information.
- Processed payments and returned receipts, cash, coin and cards to customers.
- Resolved customer complaints in a timely manner while maintaining company standards of quality and service.
- Promoted positive culture of teamwork and inclusion, increasing employee morale.
- Maintained up-to-date knowledge of store policies regarding payments, returns, and exchanges.
- Performed cashier duties when needed during peak times or shortages in personnel.
- Maintained neatness and cleanliness throughout the store environment.
- Cross-trained on different positions to best support team during peak periods.
- Led sales team to consistently deliver customer service, generating maximum sales potential.
- Monitored stock levels, identified discrepancies, and reported them to management.
- Shared product knowledge to suggest merchandise and services to customers.
- Participated in regular staff meetings to discuss ideas for promotions or special events.
- Facilitated the completion of all necessary paperwork related to sales transactions.
- Organized store displays for maximum visibility of products.
- Promoted store credit card program by offering discounts for signing up.
- Generated leads through cold calling prospective clients or attending networking events.
Education
Bogalusa High School
Bogalusa , LATimeline
Medicare Tier 2 Representative
Capitol Bridge Health Services
06.2025 - Current
Medicare A/B Claims Representative
Capitol Bridge Health Services
04.2024 - Current
Medicare Customer Service Representative
Maximus Federal
06.2022 - 04.2024
Customer Service Representative
General Dynamics
12.2016 - 03.2021
Lead Sales Associate
Dollar General
02.2016 - 12.2016
Bogalusa High School