Summary
Overview
Work History
Education
Skills
Timeline
Generic

Denise Drzewiecki

Lawrenceville,IL

Summary

Experienced military family and budget counselor specializing in safety reports, financial training, quality control, and group training. Skilled in employee management and knowledgeable in military policies and terminology. Over ten years of volunteer service within the government. Virtual employee experience with an online customer service company. Seeking a customer service role to utilize extensive expertise in sales, technical support, and payment processing. Thrives in fast-paced environments, excels at diffusing customer escalations, and adept at problem-solving.

Overview

27
27
years of professional experience

Work History

Provider Concierge Unit – PCU Professional 1

Humana, Inc
05.2019 - Current
  • Experienced reviewing medical claims.
  • Executed adjustments on claims related to Medicare and Medicaid.
  • Advanced Knowledge of claims processing
  • Analyzed extensive data files to verify accurate claim payments before release.
  • Demonstrated proficiency in CGX, Knowledge Source, MRM, Mentor, IPAR tool, Provider at a Glance, EHub, CIS, CIS PRO, and EMME.
  • Skilled in extracting claims using Claims Explorer.
  • Utilized MHK, Availity, and APEX effectively.
  • Handled SOC calls efficiently.
  • Skilled in extracting essential information from contracts.
  • Kept detailed logs of all correspondence actions.
  • Executed adjustments on claims related to Medicare and Medicaid.
  • Documented and interpreted data related to provider reimbursement programs.
  • Reviewed and adjusted pricing structures for accuracy.
  • Optimized team approaches to boost efficiency.
  • Remedied issues quickly and effectively through active listening, conflict resolution, and dynamic communication skills.
  • Managed a variety of tasks simultaneously, maintaining professionalism and efficiency under pressure.
  • Contributed to a positive work environment by maintaining a professional demeanor at all times.

Customer Service/Itunes+, FSR

Concentrix (Apple Contract)
04.2018 - 05.2019
  • Walk customers through the process of installing the software on their device
  • Troubleshoot issues customers encounter while using the software and provide actionable tips to resolve the problem
  • Provide customer service to customers with account and billing issues
  • Provide support to customers for downloads for purchases, gift cards, and locating previous download and purchases
  • Provide and maintain strong, professional relationships with all customers by achieving high standards of customer service for every customer
  • Disabled and enabled accounts, file and folder permissions and configuring security templates as per need.
  • Maintained network availability and performance monitoring and notification systems.
  • Became the lead “go-to” person for new reps and particularly challenging calls as one of the company’s primary mentors/trainers of both new and established employees.
  • Responsible for diagnosing, testing and repairing Apple Computer Systems and Mobile Devices following Apple Computer Repair Procedures.
  • Diagnose and repair hardware issues, completely built computers troubleshoot technical issues, and install software applications.
  • Install, repair, maintain, and upgrade Apple Desktop and Notebook Computers; Perform maintenance on printers.
  • UM Coordinator CIT
  • Understanding of utilizing electronic medical record and documentation programs
  • Excellent verbal and written communications
  • Inbound calls from both member and provider
  • Processes Pre-Certification request
  • Strong understanding of ICD-10 codes
  • Ability to work independently
  • Process Medical, Behavior Health, and DME request
  • Follow Process flow and Procedure Guides
  • Strong Microsoft Word, Excel, and power point skill
  • Worked on multiple projects

Customer Service/Certified Tech Support

TelePerformance (Apple Contract)
05.2017 - 03.2018
  • Configured and installed mac network systems with integrated database encryption module
  • Provided offline assistance to the clients
  • Performed troubleshooting for advanced technical issues arising in systems and network
  • Conduct tests on the faulty machines and analyze the technical problems in the hardware and configuration
  • Managed a high-volume workload within a deadline-driven environment. Resolved an average of 150 inquiries any given week and consistently met performance benchmarks in all areas (speed, accuracy, volume).
  • Became the lead “go-to” person for new reps and particularly challenging calls as one of the company’s primary mentors/trainers of both new and established employees.
  • Responsible for diagnosing, testing and repairing Apple Computer Systems and Mobile Devices following Apple Computer Repair Procedures.
  • Diagnose and repair hardware issues, completely built computers troubleshoot technical issues, and install software applications.
  • Install, repair, maintain, and upgrade Apple Desktop and Notebook Computers; Perform maintenance on printers.
  • Perform Device Configurations on Apple Mobile Devices: iPod Touch, iPhone 4S, & iPad 2 Assisted in troubleshooting user problems relating to Operating System issues, network Connectivity, TCP/IP, configuration, upgrades, MS Office products and internet connectivity
  • Deployed updates, service packs and hot fixes using Windows Update, Automatic Updates, and Group policies.
  • Disabled and enabled accounts, file and folder permissions and configuring security templates as per need.
  • Maintained network availability and performance monitoring and notification systems.

Customer Service/ Tech Support

NexReps
05.2013 - 04.2017
  • Provided business-clients with efficient support – Responded to phone calls, emails, and in-person requests.
  • Installed software, configured and tested customer PC’s, analyzed functionality of peripheral appendages.
  • Worked closely and effectively with vendors to replace/repair defective hardware and software.
  • Instructed and trained end-users regarding computer literacy.
  • Managed a high-volume workload within a deadline-driven environment. Resolved an average of 550 inquiries in any given week and consistently met performance benchmarks in all areas (speed, accuracy, volume).
  • Became the lead “go-to” person for new reps and particularly challenging calls as one of the company’s primary mentors/trainers of both new and established employees.
  • Helped company attain the highest customer service ratings (as determined by external auditors) – earned 100% marks in all categories including communication skills, listening skills, problem resolution and politeness.

Director of First Impressions/ Human Resource

Central States Mfg. Inc.
01.2012 - 04.2013
  • Problem-solved to give customers excellent service.
  • Troubled shot technical situations within the office for hardware and software issues.
  • Analyzed training needs to develop new training programs or modify and improve existing programs.
  • Planned, developed, and provided training and staff development programs, using knowledge of the effectiveness of methods such as classroom training, demonstrations, on-the-job training, meetings, conferences, and workshops.
  • Planned, managed, implemented and evaluated operations/services to insure quality cost effectiveness.
  • Analyzed data gathered and develop solutions or alternative methods of proceeding.
  • Conferred with personnel concerned to ensure successful functioning of newly implemented systems or procedures.
  • Reviewed forms and reports and confer with management and users about format, distribution, and purpose, and to identify problems and improvements.
  • Planned study of work problems and procedures, such as organizational change, communications, information flow, integrated production methods, inventory control, or cost analysis.
  • Officially commended for initiative, enthusiasm, tenacity, persuasiveness, intense customer focus and dependability in performance evaluations.
  • Completed voluntary customer service training to learn ways to enhance customer satisfaction and improve productivity.

Administration Coordinator

U. S. Army
01.2003 - 12.2011
  • Counseled individuals, groups, families, and communities regarding issues including mental health, poverty, unemployment, substance abuse, physical abuse, rehabilitation, social adjustment, child care, or medical care.
  • Interviewed clients to assess their situations, capabilities, and problems, to determine what services are required to meet their needs.
  • Served as Liaison between students, homes, schools, family services, child guidance clinics, courts, protective services, doctors, and other contacts, to help children who have problems such as disabilities, abuse, or poverty.
  • Maintained case history records and prepare reports.
  • Referred clients to community resources for services which included job placement, debt counseling, legal aid, housing, medical treatment, or financial assistance, and provide resources, such as where to go and how to apply.
  • Provided, found, and arranged for support services, such as child care, homemaker service, prenatal care, substance abuse treatment, job training, counseling, or parenting classes, to prevent more serious problems from developing.

Administration Coordinator

U. S. Marine Corps
11.1998 - 11.2002
  • Submitted reports and review reports of problems for the superior.
  • Kept records and prepared reports for management concerning visits with clients.
  • Interviewed individuals and family members to compile information on social, educational, criminal, institutional, drug history.
  • Evaluated the work of staff and volunteers to ensure that programs are appropriate quality and that resources are used effectively.
  • Recruited, interviewed, and hired volunteers and staff.
  • Established and maintained relationships with other agencies and organizations in community to meet community needs and to ensure that services are not duplicated.
  • Established and oversaw administrative procedures to meet objectives set by boards of directors or senior management.
  • Directed activities of professional and technical staff members and volunteers.
  • Prepared and maintained records and reports, such as budgets, personnel records, and training manuals.

Education

Masters of Science Management - undefined

Kaplan University
04.2014

Bachelors of Psychology - undefined

Kaplan University
06.2010

Skills

  • Strong ability to lead and train staff
  • Quality Assurance
  • Profound database management skills
  • Standards/Procedures Compliance
  • Strategic thinking
  • Distribution Management
  • Transportation/Materials Handling
  • Excellent ability to gather and analyze statistical data
  • Inventory Control Processes
  • Communicate effectively
  • Personal Computer troubleshooting skills
  • Expert with Microsoft Office Products

Timeline

Provider Concierge Unit – PCU Professional 1

Humana, Inc
05.2019 - Current

Customer Service/Itunes+, FSR

Concentrix (Apple Contract)
04.2018 - 05.2019

Customer Service/Certified Tech Support

TelePerformance (Apple Contract)
05.2017 - 03.2018

Customer Service/ Tech Support

NexReps
05.2013 - 04.2017

Director of First Impressions/ Human Resource

Central States Mfg. Inc.
01.2012 - 04.2013

Administration Coordinator

U. S. Army
01.2003 - 12.2011

Administration Coordinator

U. S. Marine Corps
11.1998 - 11.2002

Masters of Science Management - undefined

Kaplan University

Bachelors of Psychology - undefined

Kaplan University

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Denise Drzewiecki