Summary
Overview
Work History
Education
Skills
Timeline
Generic

Crystal Richmond

Blue Island,IL

Summary

I am a Strong leader and problem-solver that is dedicated to streamlining operations to decrease costs and promote organizational efficiency. I use Independent decision-making skills and sound judgment to positively impact company success. I have Team Lead Customer Service Representative skills bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. I am able to enhance customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.

Overview

32
32
years of professional experience

Work History

SCAA/MEDICAL SERVICE COORDINATOR

OPTUMSERVE-UNITED HEALTHCARE -VBA CONTRACT
07.2024 - Current

* Make contact to schedule a variety of specific medical and dental services in accordance with customer availability and contract guidelines.

* Respond to a variety of inquiries and resolve issues with regard to the Appointment.

* Maintaining sensitivity toward military culture.

* Conduct customer contact related to Health Assessment processing, referral follow up, education's and resource requirements.

* Identify Potential Behavioral Health Assessment processing, referral follow up educations, and resources requirements.

* Prior Military Experience working in the Healthcare Industry.

* Proficient Computer Skills including Microsoft Office programs such as Excel. Power Point.

* Experience with generated spreadsheet navigations, data entry and sorting.

* Experience with Word creating and editing word documents and Outlook Email and Calendar.

* Managed high-stress situations effectively. maintaining professionalism under pressure while resolving disputes or conflicts.

* Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.

* Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.

* Enhanced customer satisfaction by promptly addressing concerns and providing accurate Information.

* Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.

* Provided Coaching, Shadowing and Mentoring to fellow team members at my Supervisor Request.

* Met customer call guidelines for service levels, handles times and productivity.

* Received many 100% on QA Scores Monthly.

* Received many Kudo's and Bravo's Monthly from Veterans.

Premier Service Consultant

AT&T MOBILITY SERVICES LLC
07.2022 - 07.2024

* Answers inbound call from customers with billing issues, technical issues, or general questions regarding service.

* Assists customers questions and concerns on all products and services offered by the Company through research and resolution using various tools and systems.

* Handles telephone customer contacts. Coordinates with all sales channels for retention efforts on existing customer base.

* May sell all products and services offered by the Company.

* May help collect past due balances or take payments from customers who have been disconnected.

* Processes credit applications and activates service.

* Performs other duties as assigned by management.

Won VIP Several Times & Top 10 Loyalty Rep.

Team Leader Customer Service Representative/WFH

STERICYCLE/MAP COMMUNICATIONS
09.2014 - 06.2022

Answer urgent and non-urgent phone calls using computer-telephony integration

- Provide information, document interactions, or schedule appointments using predefined scripts and templates

* Dispatch messages/Train Dispatchers

- Deliver message content back to clients

- Training and Team Leader to CSR Teams

Administrative Asst./Coordinator/Office Manager

SRO MARKETING
08.2008 - 09.2014
  • Manage daily schedules, usually for multiple people within their organization.
  • Tasks involved with coordinating company meetings include scheduling and setting up conference rooms, securing proper equipment, arranging for video conferencing, sending reminders and arranging catering
  • Prepare a variety of documents including client proposals, letters and emails in draft and final form utilizing software programs such as Microsoft PowerPoint, Visio, Word and Excel• Monthly Travel arrangements for Managers or Supervisors
  • Answer, screen and transfer inbound phone call on a multi line phone system.
  • Administrative Duties Daily, Billing, Processing and Office Management Functions daily task,

Customer Service Rep./Claims Adjuster Rep

SEDGWICK CMS
08.2007 - 08.2008

* Responsibilities entailed a diversified amount of administrative tasks.

* Cross-trained and backed up other customer service managers.

Assign new claim to the appropriate claims handler.

Communicate clearly and professionally with the customer by telephone and/or written correspondence regarding all aspects of claim process.

Utilization Management Representative

UNICARE HEALTH/WELL-POINT
01.2008 - 05.2008
  • Responsibilities entailed a diversified amount of administrative tasks. Responsible for coordinating and opening files for Pre-Determination and Pre-Certification.
  • Determining benefits and eligibility network status.
  • Communicate clearly and professionally with customers by telephone and or written correspondence regarding all Pre-Certification and Pre-Determination.

BC/BS Claims Adjuster/Customer Service Rep.

JACOBSON SOLUTION /BLUE CROSS BLUE SHIELD OF CA
02.2006 - 05.2006

* Responsibilities entailed a diversified amount of administrative tasks;

Including adjusting claims, troubleshooting clients concerns.

* Carry out administrative tasks by communicating with clients, distributing mail and scanning documents.

Administrative Assistant

OFFICE TEAMS
03.2004 - 03.2005
  • Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
  • Supported company leaders by managing budgets, scheduling appointments and organizing itinerary.
  • Assisted coworkers and staff members with special tasks on daily basis.
  • Organized logistics and materials for each meeting and took detailed notes for later dissemination to key stakeholders.
  • Administrative Duties

Scheduler

PALOS HOSPITAL
11.2002 - 11.2003

*. Schedules appropriate tests/procedures using the Hospital Scheduling System.

* Collect all necessary demographic and Insurance Information and accurately pre-registers assigned patients into the Hospital Information System , utilizing current Hospital policies and procedures.

*. Heavy phone contact and input of pertinent data on each client daily.

* Maintain a thorough knowledge of Hospital contracted Insurance plans.

Claims Adjuster/Customer Service Representative

Aon Corporation
07.2000 - 02.2002

CLAIMS/CUSTOMER SERVICE REPRESENTATIVE

Responsibilities entailed a diversified amount of administrative task including adjusting claims, troubleshooting clients concerns.Opening new policies, interacting with customers regarding accident, life and health insurance issues.Heavy phone contact and input of pertinent data on each client daily.* Adjust Claims up to 75 a day requirement.

Emergency Room Registration/Admitting Rep.

CHILDREN’S MEMORIAL HOSPITAL
06.1997 - 12.1999

* Responsibilities entailed registering and interviewing patients, designating proper demographic information.

Insuring third party billing (Medicaid, Medicare, HMO’s, PPO’s and Commercial Insurance Plans.)

* Heavy call volume. Entering laboratory and radiology orders.

* Billing, Collection and Insurance Verification. interviewing patients, designating proper demographic information.

Insuring third party billing (Medicaid, Medicare, HMO’s, PPO’s and Commercial Insurance Plans.)

* Heavy call volume. Entering laboratory and radiology orders.

Billing, Collection and Insurance Verification.

ER Care Management I&II/ Medical Transcription

ST. FRANCIS HOSPITAL
07.1993 - 11.1996

*Responsibilities entailed full operation of the Admission and ER department, preparation of patients charts.

Insurance Verification, Billing and Collection.; transferring data to the proper area, heavy communication between patients.

* Medical Transcriptionist Cardiology Dept.

Education

Telecommunications Training

University of Chicago
Chicago, IL

Associate Of Business Administration - Business Administration And Word Processing

Robert Morris University - Illinois
Chicago, IL
09.1989

Skills

    Proficient in Opus, Rio, CRM, Customer Care, Telegance, BIBA, Express Pay, Clarify, CCKM, Windows/Mac Environment, Word, Power Point, Excel, HBOC , E-Care, Medifx and Avaya, Softphone Milliman-Coding, California MainFrame, Joyware and Anita, Ignite Soft Phone, Micollab, Mednet Main Frame, Mednet Application, Excel, Powerpoint, Word Documents, Outlook Email and Calendars

    Prior Military Experience working in HealthCare Industry

    Claims Experience for Short Term Disability, FMLA and Workers Compensation

    Strong communication and administrative abilities

    Solid supervisory skills

    Great troubleshooter and team player

    Medical Terminology

    Excelling liaison abilities;

    Articulate and Well-Groomed

    Typing 75 WPM

Timeline

SCAA/MEDICAL SERVICE COORDINATOR

OPTUMSERVE-UNITED HEALTHCARE -VBA CONTRACT
07.2024 - Current

Premier Service Consultant

AT&T MOBILITY SERVICES LLC
07.2022 - 07.2024

Team Leader Customer Service Representative/WFH

STERICYCLE/MAP COMMUNICATIONS
09.2014 - 06.2022

Administrative Asst./Coordinator/Office Manager

SRO MARKETING
08.2008 - 09.2014

Utilization Management Representative

UNICARE HEALTH/WELL-POINT
01.2008 - 05.2008

Customer Service Rep./Claims Adjuster Rep

SEDGWICK CMS
08.2007 - 08.2008

BC/BS Claims Adjuster/Customer Service Rep.

JACOBSON SOLUTION /BLUE CROSS BLUE SHIELD OF CA
02.2006 - 05.2006

Administrative Assistant

OFFICE TEAMS
03.2004 - 03.2005

Scheduler

PALOS HOSPITAL
11.2002 - 11.2003

Claims Adjuster/Customer Service Representative

Aon Corporation
07.2000 - 02.2002

Emergency Room Registration/Admitting Rep.

CHILDREN’S MEMORIAL HOSPITAL
06.1997 - 12.1999

ER Care Management I&II/ Medical Transcription

ST. FRANCIS HOSPITAL
07.1993 - 11.1996

Associate Of Business Administration - Business Administration And Word Processing

Robert Morris University - Illinois

Telecommunications Training

University of Chicago