George Cellwick

Medicare Contracted Call Center – Customer Service & Recovery Operations

Customer Service Specialist / Recovery Agent

• Delivered high-quality customer service to Medicare beneficiaries, providers, and third-party partners by resolving inquiries related to benefits, claims, eligibility, and appeals with a consistent focus on compliance, accuracy, and efficiency.
• Maintained up-to-date knowledge of CMS (Centers for Medicare & Medicaid Services) guidelines and HIPAA regulations to ensure adherence to federal standards.
• Achieved and consistently exceeded quality assurance targets, including call resolution time, customer satisfaction, and first-call resolution metrics.
• Promoted to a dual-role position due to exemplary performance, attention to detail, and ability to handle complex issues with minimal supervision.

As Recovery Agent:

• Investigated and processed Medicare Secondary Payer (MSP) recovery claims by reviewing documentation, identifying overpayments, and initiating reimbursement procedures.
• Collaborated with insurance carriers, attorneys, and Medicare beneficiaries to facilitate accurate recovery of funds in compliance with federal laws.
• Utilized internal systems to document case activity, track progress, and generate reports for audit purposes.
• Played a key role in reducing backlog and improving process flow by proactively identifying inefficiencies and suggesting system enhancements.

• Medicare Policy & CMS Compliance
• Customer Service Excellence
• Claims Resolution & Appeals
• Medicare Secondary Payer (MSP) Recovery
• HIPAA Compliance
• Call Center Operations
• Conflict Resolution
• Data Entry & Case Documentation

• Coordinate roadside and emergency services for high-end automotive customers. The ability to critically think and develop courses of action in a complex, dynamic and ever-changing customer needs. Responsible to articulate and convey a clear message to the customer offering the best support options to provide the services needed by the customers by simultaneously maintaining an excellent level of customer satisfaction. Provide several bank services to worldwide customers of USAA Bank mostly active service member their families and retirees. Responsible to maintain a high level of customer support and satisfaction while recommending different services in order to resolve or answer every USAA member problem or questions.

• Constant interaction with customers in all situations, training new associates, running registers, placing customer orders, keeping track of metric numbers for self and all Booksellers, in-depth knowledge of store and product placement. Constant Stellar Seller of the month and instrumental in making high numbers of sales for the entire store due to outstanding rapport with customers.

• Greet customers at the door with a positive attitude, even in the high paced environment; answer phones, place call ahead seating, seat customers, clean up the host area. Providing great customer experience and satisfaction while dining.

• Opened and Closed the store, including counting cash drawers and making bank deposits; I was able to help customers with any questions, and address any problems or concerns in person or via phone. In-depth knowledge of all electronics, games, gaming systems was a great asset to working there.