Carle Parrish

Jacksonville,FL

Summary

Initiative-taking and resourceful customer service representative with proven competency in purposeful environments. Expertise includes solid experience in defining and analyzing customer requests to resolve issues accurately and quickly with high first contact resolution rates. Strong computer skills in a Windows-based environment and proven ability to learn unique software. Confident and effective communicator who receives excellent customer feedback.

Overview

years of professional experience

Work History

Account Representative / Loss Mitigation

Ally Financial Inc.

01.2020 - Current

Research and problem solve customer/dealer issues and provide effective solutions that meet the customers' needs. Accurately update systems and databases with status details and other information relating to customer concern or need.
Maintain strict confidentiality with customer, employee, and company information.
Accountable for reducing delinquency for assigned accounts. Providing customer service regarding collection issues, process, and review account adjustments, resolve client discrepancies and short payments.
Responsible for monitoring and maintaining assigned accounts.
Respond to customer inquiries via telephone, Shaw workflows, CRTS and/or e-mails within established period.
Evaluate accounts to find a solution to avoid repossession loss.
Document all accounts accurately, clearly, and concisely noting reason for hardship and potential repossession loss.

Insource Facilities Management

Walmart

01.2018 - 01.2020

Log jobs, assign resources, answer any follow up inquiries, ensure ETAs meet the response times, serve to assist with reducing Vendor spend, and assist to ensure jobs are completed timely.
Maintain basic system configuration, enhancements, and report trending analysis for Effectively communicate with all levels of leadership and associates.
Manage all activities to effectively manage workload and KPIs/SLAs improvement needs. Responsible for answering inbound calls and initiating outbound calls in a timely and efficient manner and acts as liaison between field associates and store managers to ensure all maintenance jobs are completed.
Ability to liaison with field associates and vendors to prioritize calls.
Help customers with complaints and questions, give customers information about products and services, take orders, and process returns.
Managed high call volume with tact and professionalism. Manage and resolve customer complaints.

Redetermination Analyst

First Coast Service Options (Subsidiary of Florida Blue)

01.2016 - 01.2018

Receiving appeal request from providers on services that were previously denied by Medicare.
Adjust or uphold denial of services and send out communication to the appropriate party in a timely manner. All requests are reviewed by a medical nurse and with appropriate documentation a decision is made whether to deny or approve for payment.
Providing rendered to recipients of Medicare. CMS (Centers for Medicare and Medicaid Services) guidelines and regulations are thoroughly enforced.
Submitting files for an appeal review by beneficiaries. These files are carefully researched and reviewed and managed in a case sensitive manner to get an accurate and correct appeal decision. Once a decision has been obtained, correspondence is then sent by mail to both parties involved (Beneficiary and Provider). All guidelines are set forth by CMS (Center for Medicare Services).

Medicare Advantage Associate (Medicare part D)

Florida Blue

01.2014 - 01.2016

Assisting Medicare recipients with their prescription drug plan inquiries.
Updating information such as address changes, date of birth corrections and other insurance information. Making sure members have Medicare Part A and B before applying for a prescription drug plan with Florida Blue.
Assisted with billing inquiries. Work closely with Medicare system CMS (Centers for Medicare and Medicaid Services) to ensure that what we have on file coincides with what Medicare has in their system.
Performed SME (subject matter expert) duties for newly hired employees on a weekly basis. Service Associate - Florida Blue 2013 - 2016
Responsible for the processing of provider and subscriber claims (Medicare A and B processing of suspense claims and written inquiries, and Medicare B query and auditing of suspense claims, adjudicating payments according to contract benefits.
Indebt knowledge of ICD-9 diagnosis coding.
Performed customer service duties briefly, took inbound calls from subscribers and providers assisting with benefit.

Education

High School Diploma -

North Florida

Jacksonville, FL

05.2013

Skills

Microsoft Word, Excel, Access, PowerPoint, Outlook Express
Transcription and proofreading experience (30 wpm, 10-key)

Extremely productive in a high volume, high stress, environment
Clear communication skills aimed at understanding customers’ needs and providing corresponding services

Timeline