DEANTE PENNY
North Royalton,OH
Summary
Highly experienced and dedicated Senior Customer Service Representative with a proven track record of delivering exceptional support within the medical insurance industry. Possessing a deep understanding of healthcare policies, claim processing, and customer-centric communication, I am adept at resolving complex inquiries and providing valuable guidance to clients. With a strong commitment to efficiency, accuracy, and client satisfaction, I strive to exceed expectations and uphold the organization's reputation.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
Medical Mutual Of Ohio And Its Family Of Companies
Cleveland, OH
08.2022 - Current
- Addressed a wide range of customer inquiries related to medical insurance policies, claims, billing, and eligibility criteria promptly and accurately.
- Demonstrated in-depth knowledge of Medical Mutual of Ohio's insurance products and services to provide personalized assistance and guidance to customers.
- Processed insurance claims efficiently, ensuring adherence to company policies and regulatory requirements.
- Resolved escalated customer issues in a timely and empathetic manner, effectively de-escalating tense situations and maintaining a high level of customer satisfaction.
- Utilized Microsoft Office Suite and ADP software to manage customer records, document interactions, and generate reports to track customer feedback and service performance metrics.
- Collaborated closely with cross-functional teams, including claims processing, underwriting, and sales departments, to address customer concerns and improve overall service quality.
- Participated in ongoing training sessions to stay updated on changes in medical insurance regulations, policies, and procedures, ensuring accurate and informed customer assistance.
- Consistently met or exceeded performance targets for call resolution times, customer satisfaction scores, and quality assurance metrics.
Claims Specialist
Mutual Health Services
Cleveland, OH
11.2017 - 03.2020
- Process routine to moderately complex healthcare claims and/or adjustments while providing customer service via inbound/outbound phone calls and written communications Under direction of more senior staff, conducts routine claims research in response to inter/intra- departmental inquiries Assists with projects as directed by management.
- Provided quality customer service to all assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Evaluated customer account information to assess current issues and determine potential solutions.
Account Rep II
Cleveland Clinic
01.2017 - 11.2017
- Recommend and execute policies to the supervisor to ensure the timely resolution of patient service and third party reimbursement issues to foster an environment of total customer responsiveness.
- Perform Customer Service, insurance billing and follow up processes for commercial and government payers, insurance verification, cash application, credit balance resolution and account reconciliation.
- Assist in implementation and execution of a quality control program for the timely and accurate resolution of patient and insurance inquiries.
Client Advocate Specialist
Equity Trust Company
01.2014 - 01.2017
- Profile new and prospective clients to assign to Senior Account Executives Resolved client account issues Met with prospective clients and presented at real estate trade shows.
Customer Service and Fee Recovery Specialist
Equity Trust Company
01.2012 - 01.2014
- Managed IRA accounts with potential cross sales opportunities, and generated profitable leads from Salesforce account client base.
Education
Masters of Business Administration -
University of The South West (USW)
2017
Bachelor of Arts - Communications
Bowling Green State University (BGSU)
2012
Skills
- Proficient in medical insurance terminology and policies
- Advanced knowledge of claim processing procedures
- Exceptional communication skills, both verbal and written
- Strong problem-solving abilities, particularly in resolving complex customer issues
- Ability to multitask and prioritize tasks effectively in a fast-paced environment
- Excellent interpersonal skills, fostering positive relationships with clients and colleagues
- Proficiency in utilizing CRM systems, Microsoft Office Suite, including Word, Excel, and Outlook, and ADP software for efficient customer support
Affiliations
Awarded and Recognized as Equity Trust Company Shining Star 2015
Additional Information
- Experience in tax preparation, event planning, and virtual assistance
Accomplishments
- Competitive Analysis - Performed competitive analysis to make recommendations for future company growth.
- Process Improvement - Created new departmental procedures manual. Assessed organizational training needs.
Timeline
Customer Service Representative
Medical Mutual Of Ohio And Its Family Of Companies
08.2022 - Current
Claims Specialist
Mutual Health Services
11.2017 - 03.2020
Account Rep II
Cleveland Clinic
01.2017 - 11.2017
Client Advocate Specialist
Equity Trust Company
01.2014 - 01.2017
Customer Service and Fee Recovery Specialist
Equity Trust Company
01.2012 - 01.2014
Masters of Business Administration -
University of The South West (USW)
Bachelor of Arts - Communications
Bowling Green State University (BGSU)
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