CAROLYN REID
Fern Park,FL
Summary
Detail-oriented professional with 14+ years of experience in healthcare, insurance claims, and customer service. Proficient in claims processing, OTC benefit administration, and client education. Recognized for exceeding KPIs in customer satisfaction, call resolution time, and enrollment accuracy. Skilled at problem-solving, data integrity, and ensuring compliance with healthcare regulations. Seeking to leverage diverse expertise in a dynamic role at UnitedHealth Group.
Overview
1
1
Certification
48
48
years of professional experience
Work History
Customer Service Representative
Ansafone
Ocala, FL
08.2022 - Current
- Delivered outstanding customer support for OTC benefits, Healthy Foods programs, and insurance inquiries, achieving 98% customer satisfaction scores.
- Resolved client issues with an average first-call resolution rate of 92%, exceeding team standards.
- Processed and tracked benefits claims for OTC and food programs, ensuring timely and accurate administration.
- Consistently met KPIs for productivity, quality, and adherence to schedules, handling an average of 80+ calls per shift.
- Educated clients on benefit usage and program eligibility, enhancing service understanding and participation.
Private Duty Nurse / Consultant
Residential Homecare
Enterprise, AL
01.2014 - 01.2020
- Delivered personalized home healthcare services, including medication administration and treatment monitoring.
- Provided patient care support, including assisting with daily living activities and nutritional meal preparation.
- Coordinated medical appointments to facilitate continuity of care.
Licensed Practical Nurse (LPN)
Florida
01.2001 - 01.2003
- Conducted patient assessments and developed tailored care plans.
- Administered prescribed medications and monitored patient progress.
- Supported health monitoring through routine vitals and feeding assistance.
Cashier
S&S Foods
Lake City, FL
01.1984 - 01.1985
- Processed transactions and maintained accuracy in financial exchanges.
- Offered excellent customer service.
- Addressed any customer concerns or issues.
Nurse Escort
Lake Shore Hospital
Lake City, FL
01.1979 - 01.1980
- Assisted patients with daily living activities under nursing supervision.
Education
Certificate for Practical Nursing -
Santa Fe College
Gainesville, FL01.1988
High School Diploma -
Columbia High School
Lake City, FL01.1980
Skills
- Claims Processing and Adjudication
- OTC Benefits Administration
- Customer Service
- Problem Resolution
- Microsoft Excel
- Microsoft Word
- Healthcare Compliance and Regulations
- Effective Communication
- Team Collaboration
Certification
- Certified Claims Professional (CCP), Pending
- Associate in Claims (AIC) Certification, Pending
Timeline
Customer Service Representative
Ansafone
08.2022 - Current
Private Duty Nurse / Consultant
Residential Homecare
01.2014 - 01.2020
Licensed Practical Nurse (LPN)
01.2001 - 01.2003
Cashier
S&S Foods
01.1984 - 01.1985
Nurse Escort
Lake Shore Hospital
01.1979 - 01.1980
Certificate for Practical Nursing -
Santa Fe College
High School Diploma -
Columbia High School