Christina Frederic
Jacksonville
Summary
Dedicated professional with demonstrated strengths in customer service, time management, and being a reliable employee. Good at troubleshooting problems and building successful solutions. Excellent verbal and written communicator, with a strong background in cultivating positive relationships and exceeding goals. Capable and experienced, working in challenging environments. Dependable employee seeking an opportunity to expand my skills and contribute to the company's success. Considered hardworking, ethical, and detail-oriented. Excited about future opportunities in the next career step.
Overview
12
12
years of professional experience
Work History
Medicare Appeals & Grievances Coordinator
Florida Blue - Blue Cross Blue Shield Of Florida
Jacksonville
08.2016 - Current
- Prepared written responses to customers regarding the status of their appeal or grievance filings.
- Collaborated with other departments within the organization to identify potential solutions for resolving customer disputes.
- Trained new employees on company policies, procedures, and best practices for managing appeals and grievances.
- Supported team members during periods of high caseloads or tight deadlines by assisting with their tasks when needed.
- Followed up on unresolved cases to keep customers informed of progress towards solution.
- Conducted thorough investigations of complaints submitted by customers. Facilitated communication between customers and relevant parties throughout resolution process.
- Developed strategies to minimize occurrence of customer complaints requiring escalation to appeal or grievance status.
- Identified trends in customer complaints and provided recommendations for changes in procedures or policies.
- Provided customers with timely updates on their complaint status.
- Evaluated existing policies and procedures related to handling customer complaints.
- Investigated customer complaints to identify root causes and develop corrective actions.
Claims Resolution Specialist I
Florida Cancer Specialists
Jacksonville
12.2024 - 08.2025
- Reviewed claim documents, including medical records and invoices, to ensure information accuracy.
- Adhered to workflow processes and timelines to meet performance objectives.
- Managed inquiries and payment denials, responding to insurance carriers' documentation requests.
- Collected on open account balances.
- Utilized knowledge of insurance billing, reimbursement, medical terminology, ICD-9, and CPT codes.
- Experience in medical billing and collections using EMR or GE Centricity software.
- Expertise in the fields of Medical Oncology, Radiology, Radiation, Laboratory, and Pathology.
Customer Service Representative
Florida Blue - Blue Cross Blue Shield Of Florida
Jacksonville
08.2016 - 06.2020
- Proficiently handled critical customer inquiries, ensuring prompt resolution and high levels of satisfaction.
- Focus on resolving questions and issues, helping customers utilize our products, tools, and services directly.
- Delivered exceptional customer service by promptly documenting, thoroughly investigating, and successfully resolving various customer issues.
- Managed difficult customer situations with professionalism and empathy. Navigated multiple computer systems and utilized search tools to find information.
- Deliver exceptional customer service, effectively resolving complaints within specified timelines.
- Assisted customers with filing new claims, updating existing claims, and resolving disputes.
- Researched and resolved claims inquiries from members.
- Answered customer questions regarding billing issues.
- Processed appeals on denied claims as necessary.
- Researched insurance claims issues when necessary.
- Resolved customer complaints regarding service or billing issues.
- Managed customer accounts, including billing inquiries and payments.
Customer Service Representative
ADT Security
Jacksonville
03.2014 - 08.2016
- Managed 100 calls per day efficiently in fast-paced call center environment.
- Collaborated across departments to resolve customer-related issues.
- Managed difficult customer situations with professionalism and empathy.
- Addressed and resolved customer concerns and complaints.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
Customer Service Representative
Convergys
Jacksonville
09.2013 - 03.2014
- Enhanced customer satisfaction with fast, knowledgeable service.
- Built trusting relationship with customers to better understand needs. Resolved product or service issues by clarifying customer complaints and offering appropriate solutions.
- Informed customers about billing procedures, processed payments and provided payment option setup assistance.
- Increased customer satisfaction ratings 100% by effectively answering questions, suggesting effective solutions and resolving issues quickly.
- Customer Service Representative Handle questions via phone, upgrades or troubleshooting issues, addressing billing information.
Education
Miramar, FL -
Miramar High School
Miramar, FL06-2010
Skills
- Excellent communication
- Problem resolution
- Strong analytical skills
- Data entry
- Complaint resolution
- Technical support
- Claims review
- Excellent communication
- Problem resolution
- Strong analytical skills
- Data entry
- Complaint resolution
- Technical support
- Claims review
Timeline
Claims Resolution Specialist I
Florida Cancer Specialists
12.2024 - 08.2025
Customer Service Representative
Florida Blue - Blue Cross Blue Shield Of Florida
08.2016 - 06.2020
Medicare Appeals & Grievances Coordinator
Florida Blue - Blue Cross Blue Shield Of Florida
08.2016 - Current
Customer Service Representative
ADT Security
03.2014 - 08.2016
Customer Service Representative
Convergys
09.2013 - 03.2014
Miramar, FL -
Miramar High School
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