Ashley Roseberry
Dallas,USA
Summary
Experienced Customer Service Representative with a strong focus on effective communication, active listening, and problem-solving. Dedicated to enhancing customer experiences by consistently delivering service-oriented behaviors and understanding their desires. Aims to build loyalty and ensure customer satisfaction through customized solutions.
Overview
18
18
years of professional experience
1
1
Certification
Work History
SR OON CUSTOMER SERVICE SPECIALIST
MULTI PLAN
Irving, TX
04.2021 - Current
- Investigate, analyze, research, and resolve complex and escalated claim inquiries from patients, clients, providers, and internal customers' as a result of issues related to discounts, payments and balance billing
- This includes handling legal inquiries or department of insurance complaints
- Provide resolution and closure to the applicable recipients
- Create and execute business correspondence to clients or providers using multiple media formats such as but not limited to emails, form letters, and issues specific letters
- This includes initiating resolution and follow up calls to clients and providers
- Adhere to client turn around requirements as it relates to response time and required actions
- Ensure investigative notes related to any contact with providers and clients are documented and accessible throughout the applicable systems
- Ensure the maintenance of and compliance with department standards for production, accuracy, and turnaround time
- Perform system claim adjustments based on outcomes and communicate with client regarding confirmation
- Assume and resolve escalated claim and inquiries from team members
- Serves as back-up for team members, or Leadership
- Coach and mentor less experienced team members on claims handling, resource utilization, and appropriate resolutions
- May include call center responsibilities, including adhering to call center standards
- Assist in training new team members as needed and providing feedback to Leadership
- Various research projects for Sr
- Management and Clients, as assigned
- Collaborate, coordinate, and communicate across disciplines and departments
- Ensure compliance with HIPAA regulations and requirements
- Demonstrate Company's Core Competencies and values held within
- Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role
- The position responsibilities outlined above are in no way to be construed as all encompassing
- Other duties, responsibilities, and qualifications may be required and/or assigned as necessary
Medical Collector
Medix Temp Agency
Dallas, TX
10.2020 - 01.2021
- Research and resolve accounts for maximum reimbursements
- Examines all documents to ensure bills are compliant
- Determines appropriate steps and communicates critical information to insurance companies and leadership both verbally and in writing
- Ensure concerns are resolved in a timely manner and accounts are settled in full
Senior Billing Representative
Inform Diagnostics
Irving, TX
01.2017 - 01.2020
- Research and resolve accounts for maximum reimbursements
- Examines all documents to ensure bills are compliant
- Determines appropriate steps and communicates critical information to insurance companies and leadership both verbally and in writing
- Ensure concerns are resolved in a timely manner and accounts are settled in full
Billing Representative
Miraca Life Sciences
Irving, TX
02.2016 - 01.2017
- Assist patients, clients, and insurance companies with account balances on multiple line phone systems
- Review explanation of benefits from insurance companies to ensure accuracy of patient's accounts
- Determine account resolution by working with A/R team regarding status of submitted claims and appeals
- Apply and review adjustments and payments on patient's accounts
- Submit claims through medical billing system Quadax
- Process payments and arrangements using Payor
- Received a promotion to be a Senior Billing Representative
Data Entry Clerk
Manpower Group
10.2015 - 11.2015
- Company Overview: Temporary
- Prepared and sorted documents/ data sheets for the purpose of data entry
- Established entry priorities by maintaining understanding of what data needs to be entered first
- Entered customer data into prescribed database software
- Checked to make sure that accurate data has been entered into the database
- Temporary
New Patient Representative
Western Dental Services
Lewisville, TX
06.2015 - 08.2015
- Booked new and existing patients for dentist appointments
- Up sold orthodontics appointments
- Navigated through various systems to schedule, confirm, or cancel appointments
Dispatcher
Carey International
Dallas, TX
02.2015 - 04.2015
- Assigned and dispatch drivers and/or chauffeurs to fulfill ground transportation reservations and requests
- Assigned drivers and/or chauffeurs in a fair and equal manner based on vehicle type, schedule, and availability of driver and/or chauffeurs
- Assisted reservations with questions concerning rates and drive times
- Answered customer questions in regards to schedule changes, availability of vehicles, and existing reservations
Customer Service Representative
Iqor
Richardson, TX
10.2014 - 01.2015
- Took monthly insurance payments from members
- Provided customers with insurance information
- Updated accounts
Roadside Assistance
Novo 1
Fort Worth, Texas
05.2011 - 09.2014
- Assisted customers with directions
- Dispatched tow trucks
- Provided prompt courteous customer assistance
- Took inbound calls averaging 50-75 calls per day
Cashier
American Airline Center
Dallas, TX
01.2007 - 06.2009
- Interfaced with a variety of customers
- Cash handling
- Inventory checks
- Up sell
- Maintained financial balance sheet
Education
High school or equivalent -
Justin Ford Kimball High School
Dallas, TX05.2006
Skills
- Microsoft Excel
- Customer service
- HIPAA
- Data entry
- Microsoft Word
- Customer Service
- Good communication skills
- Call center experience
- Excellent written and oral communication
- Telephone Etiquette
Accomplishments
I made Top Performer for two quarters in a row at my current job Multiplan in 2023. I also passed my assessment exam to receive my license to be a Claims Adjuster 7/2024.
Groups
Recognition Committee, 03/01/16 to Present, We get all the departments to vote on who they think should receive an award for the month.
Assessments
Attention to Detail, Proficient, 09/01/20, Identifying differences in materials, following instructions, and detecting details among distracting information.
Additionalinformation - Summaryofskills
14 years of customer service experience. Excellent written and verbal communication skills. Detailed oriented. Extremely productive in a high volume, high stress, fast paced environment. Proficient in the use of Microsoft Office products.
Personal Information
Work Permit: Authorized to work in the US for any employer
Awards
Quarterly Quality Award, 06/2014
Certification
I have my Certification of Completion for Texas All-Lines Adjuster Online Pre-Licensing so I received my license to be a claims adjuster 7/2024.
Timeline
SR OON CUSTOMER SERVICE SPECIALIST
MULTI PLAN
04.2021 - Current
Medical Collector
Medix Temp Agency
10.2020 - 01.2021
Senior Billing Representative
Inform Diagnostics
01.2017 - 01.2020
Billing Representative
Miraca Life Sciences
02.2016 - 01.2017
Data Entry Clerk
Manpower Group
10.2015 - 11.2015
New Patient Representative
Western Dental Services
06.2015 - 08.2015
Dispatcher
Carey International
02.2015 - 04.2015
Customer Service Representative
Iqor
10.2014 - 01.2015
Roadside Assistance
Novo 1
05.2011 - 09.2014
Cashier
American Airline Center
01.2007 - 06.2009
High school or equivalent -
Justin Ford Kimball High School