Denise Mitchell
New Orleans,LA
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
6
6
years of professional experience
Work History
Customer Service Representative
UnitedHealthcare
Minnetonka, MN
06/06/20 - Current
- Answered customer inquiries and provided accurate information regarding products and services.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Answered inbound calls, chats and emails to facilitate customer service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Developed strong relationships with customers by providing personalized assistance and support.
- Consulted with customers to resolve service and billing issues.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Assisted customers with making payments or establishing payment plans to bring accounts current.
- Made outbound calls to obtain account information.
- Improved customer service wait times to mitigate complaints.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Updated databases with new and modified customer data.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Documented changes in claim statuses using specialized software systems.
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Scheduled and confirmed appointments.
- Entered information into system to update status reports.
- Communicated schedule changes effectively throughout the organization when necessary.
- Followed all Medicare, Medicaid, HIPAA and private insurance regulations and requirements.
- Verified patient's insurance eligibility prior to appointment date for payment purposes.
- Notified ordering providers of denied authorizations.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
- Answered customer inquiries regarding billings, payments, account status.
- Worked closely with other departments to ensure quality customer service delivery.
Designated Hitter
Walgreens
Metairie, LA
02.2022 - 08.2023
- Verified patient information to ensure accuracy of prescriptions filled.
- Assisted pharmacy staff with prescription filling and other tasks as needed.
- Resolved customer complaints in a professional manner while maintaining company policies and procedures.
- Processed payments accurately using cash registers and credit card machines.
- Answered customer questions and referred to pharmacist for medication information.
- Assisted customers with locating specific items within the store.
- Answered phone calls from customers regarding product availability and pricing information.
- Monitored expiration dates on products stored in the pharmacy area.
- Greeted customers, provided excellent customer service, and answered inquiries in a timely manner.
Referral Specialist
West Jefferson Hospital
Marrero, LA
09.2017 - 05.2020
- Communicated regularly with referring physicians, nurses, case managers, social workers, and other healthcare professionals regarding referral processes and requirements.
- Tracked progress of each referral throughout its lifecycle from submission through authorization or denial notification.
- Tracked referral request progress and resolved issues to maintain smooth processing.
- Assisted patients in understanding their insurance coverage and answered questions about referrals, authorizations, and other related issues.
- Gathered and verified insurance requirements to meet payer requirements.
- Reviewed all documentation associated with each referral request to ensure compliance with relevant regulations.
- Assisted patients by answering questions and providing information regarding referrals.
- Contacted patients to confirm or reschedule appointments to minimize no-show appointments.
- Monitored changes in payer policies related to referral processing and communicated those changes internally.
- Collected required signatures to initiate referral process.
- Scheduled patients according to availability, urgency and insurance authorization guidelines.
Education
High School Diploma -
Bonnabel Magnet Academy High School
Kenner, LA05-2008
Skills
- Account Updating
- Information Security
- Consultative Sales
- Inbound and Outbound Calling
- Appointment Scheduling
- Data Collection
- Scheduling
- Paperwork Processing
- Data Entry
- Follow-Up Skills
- Phone Inquiries
- Scheduling Proficiency
- Customer Service
References
References available upon request.
Timeline
Designated Hitter
Walgreens
02.2022 - 08.2023
Referral Specialist
West Jefferson Hospital
09.2017 - 05.2020
Customer Service Representative
UnitedHealthcare
06/06/20 - Current
High School Diploma -
Bonnabel Magnet Academy High School