Summary
Overview
Work History
Education
Skills
Timeline
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Erica M. Cole

Smyrna,GA

Summary

Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.

Self-motivated Customer Service Representative with 15+ years of experience in meeting the needs of both customers and providers. Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options.

Overview

16
16
years of professional experience

Work History

Provider Data Specialist

Optum
04.2022 - Current
  • Responsible for various research and loading activities related to provider network database
  • Research provider information using programs such as Plinx, Facets, Sales Force and SharePoint
  • Initiate request to properly maintain the provider data housed in company database to allow for proper claim payments and member directory information
  • Respond to provider request to terminate contracts and send request for additional information via email
  • Self-motivated, with strong sense of personal responsibility
  • Proven ability to learn quickly and adapt to new situations
  • Managed time efficiently in order to complete all tasks within deadlines

Customer Service Associate

United Behavioral Health
12.2013 - 05.2022
  • Handled customer inquiries and suggestions courteously and professionally
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
  • Answered constant flow of customer calls with minimal wait times
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
  • Offered advice and assistance to customers, paying attention to special needs or wants
  • Clarified customer issues and determined root cause of problems to resolve product or service complaints
  • Participated in team meetings and training sessions to stay informed about product updates and changes
  • Managed over 50 customer calls per day.

CUSTOMER SERVICE REPRESENTATIVE

Highmark Blue Cross Blue Shield Delaware
07.2012 - 04.2013
  • Supported incoming callers by managing claims, benefits, and enrollment requests
  • Maintained an accurate member database by carefully documenting benefit quotes and other details
  • Primarily responsible for resolving outstanding inquiries within member database
  • Managed over 50 customer calls per day
  • Responded to customer requests for products, services, and company information
  • Clarified customer issues and determined root cause of problems to resolve product or service complaints
  • Participated in team meetings and training sessions to stay informed about product updates and changes

MEMBER CORRESPONDENCE REPRESENATIVE, Independence Blue Cross
06.2007 - 07.2010
  • Managed written and electronic correspondence from members regarding claim status, claim payments and benefit information
  • Maintained accurate member database by entering Independence Blue Cross and non Independence Blue Cross HIPAA authorizations
  • Reviewed and approved documents such as Power of Attorney, Short Certificates, Death Certificates and other court order documents for eligibility
  • Generated member correspondence, such as benefits notices, letters of eligibility, and benefits
  • Managed over 50 documents per day
  • Demonstrated respect, friendliness and willingness to help wherever needed
  • Proved successful working within tight deadlines and a fast-paced environment

Education

Some College (No Degree) - Nursing

Independence University, Community College of Philadelphia
Salt Lake City, Philadelphia, UT, PA

High School Diploma -

Martin Luther King High School
Philadelphia, PA
06.1996

Skills

  • Administrative Support
  • Goals and Performance
  • Data Communications
  • Electronic Filing System
  • Exceptional Attention to Detail
  • Analytical Skills
  • Information Processing
  • Call Triaging
  • Recordkeeping Strengths
  • Proofreading
  • Spreadsheets
  • Customer Service

Timeline

Provider Data Specialist

Optum
04.2022 - Current

Customer Service Associate

United Behavioral Health
12.2013 - 05.2022

CUSTOMER SERVICE REPRESENTATIVE

Highmark Blue Cross Blue Shield Delaware
07.2012 - 04.2013

MEMBER CORRESPONDENCE REPRESENATIVE, Independence Blue Cross
06.2007 - 07.2010

Some College (No Degree) - Nursing

Independence University, Community College of Philadelphia

High School Diploma -

Martin Luther King High School

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Erica M. Cole