Crystal J. Love
Green,NC
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening, and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, and providing customized solutions to build loyalty. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
16
16
years of professional experience
Work History
Aetna One Advocate
Aetna Inc. CVS
06.2019 - Current
- Explain insurance Benefits, Eligibility dates, and claim details.
- Assist patients with pre-authorization status for upcoming medical procedures.
- Respond to members' inquiries via phone, email, and chat, providing accurate information and efficient problem resolution.
- Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
- Collaborated with the quality analyst development teams to communicate customer feedback and contribute to service enhancements.
Business Customer Service
AT&T
09.2014 - 09.2017
- Responsible for inbound and outbound credits and collections, activations, customer service, E-services, fraud, and business support.
- Provide technical support for individual equipment as well as reported problem areas including cell tower outages.
- Educated customers about billing, payment processing, and support policies and procedures.
Claims Processor
LabCorp
04.2011 - 04.2012
- Determine the appropriate reimbursement amount based on contract terms, fee schedules, and coverage limits
- Investigate and resolve claim denials, rejections, and appeals by researching discrepancies and following up with relevant parties.
- Utilized specialized software to process incoming claims, enter data, and generate reports.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Managed workload and priorities to meet claims processing deadlines.
Customer Service Specialist
United Healthcare
02.2008 - 04.2011
- Explain insurance benefits, co-pays, deductibles, and other financial responsibilities to patients
- Assist patients with pre-authorization requirements and referrals as needed.
- Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
Education
Bachelor of Arts - Marketing & Management
The Art Institute of Charlotte
Charlotte, NCSkills
- Customer Account Management
- Claims
- System Updates
- Customer Relations
- Conflict Resolution
- Microsoft Office
- Investigate Claims
- Policy and Procedure Adherence
- Technical Knowledge
- Creative Strategies
- Medical Communications
- Call Center Technology
Timeline
Aetna One Advocate
Aetna Inc. CVS
06.2019 - Current
Business Customer Service
AT&T
09.2014 - 09.2017
Claims Processor
LabCorp
04.2011 - 04.2012
Customer Service Specialist
United Healthcare
02.2008 - 04.2011
Bachelor of Arts - Marketing & Management
The Art Institute of Charlotte
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