Ciara Sterling
Houston,TX
Summary
Communicative customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound calls and sustaining satisfactory relationships with customers. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.
Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Overview
4
4
years of professional experience
Work History
Insurance Verification Specialist
Humana
Florida, NY
01.2021 - 01.2024
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Assisted in resolving claim issues related to billing and reimbursement inquiries.
- Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
- Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
Customer Service Representative
Just energy
Dacada, WI
04.2020 - 12.2023
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
Customer Service Representative
Humana
Florida, NY
10.2022 - 01.2023
- Answered customer inquiries and provided accurate information regarding products and services.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
Education
High School Diploma -
Cypress Lakes High School
Katy, TX07-2014
Skills
- Complaint Resolution
- Consultative Sales
- Information Security
- Appointment Scheduling
- Inbound and Outbound Calling
- Paperwork Processing
- Account Updating
- Call Management
- Data Collection
- Problem-Solving Abilities
- Insurance verification
Timeline
Customer Service Representative
Humana
10.2022 - 01.2023
Insurance Verification Specialist
Humana
01.2021 - 01.2024
Customer Service Representative
Just energy
04.2020 - 12.2023
High School Diploma -
Cypress Lakes High School
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