Summary
Overview
Work History
Education
Skills
Timeline
Generic

Gina Pierce

Horizon City,TX

Summary

Successful Customer Service Representative with five years of experience addressing customer requests and concerns. Experts provide relevant information and options to effectively resolve issues. Upbeat and energetic with grace in handling difficult situations through resourcefulness and adaptability.

Overview

24
24
years of professional experience

Work History

Provider Claim Support

Centene Corp
05.2023 - Current
  • Maintain IRS conformity by monitoring the claims automation system for changes in vendor participation.
  • Handle veteran compensation claims per law, both inside business and at the federal level
  • Analyzes service contracts to extract overpayment detection algorithms based on price schedules and other contractual clauses
  • Examine and process claims from HMO facilities and professionals, allocating benefits per policy and plan guidelines.

Provider Service representative

Centene Corp
  • Assisted members with correcting accounts, service, and system issues by providing education on required forms and technical processes
  • Maintained updated knowledge of internal processes and industry best practices to optimize service delivery
  • Maintained accurate and current customer account data with manual form processing and digital information updates
  • Learned all internal systems and related service roles and duties to provide skilled team backup in handling customer demands
  • Followed up with customers regularly via phone and email to obtain payments and schedule services
  • Described and explained details about Ambetter Health Insurance options to inform customers and guide purchasing decisions
  • Learned and maintained an in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions
  • Evaluated customer information to explore issues, develop potential solutions, and maintain high-quality service

Customer Service Specialist

ContinuumRX
03.2020 - 05.2020
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards
  • Maintained accurate and current customer account data with manual form processing and digital information updates
  • Evaluated customer information to explore issues, develop potential solutions, and maintain high-quality service
  • Built client rapport while accurately processing repair documentation and troubleshooting technical discrepancies through the completion
  • Improved daily operations, vendor relationships, contractor communication, and employee remote access by streamlining processes
  • Researched issues through the identification of similar past problems and recommended themost appropriate solution
  • Preserved revenue streams by utilizing strong communication and negotiation skills, offering refunds as a last resort to maintain customer satisfaction
  • Answered over 50 calls per day to meet fast-paced call center demands

Customer Service Specialist

Dial America
09.2019 - 02.2020
  • Delivered exceptional customer service on all calls while maintaining calm and professional demeanor in challenging circumstances
  • Resolved complaints efficiently to satisfy customers and encourage future transactions
  • Evaluated customer information to explore issues, develop potential solutions, and maintain high-quality service
  • Built long-term, loyal customer relationships by providing top-notch service and detailed order account and service information.
  • Answered phone with friendly greetings to create a positive inbound calling experience for customers
  • Assisted team leaders by providing timeframe status and performance reports to provide information on areas for improvement
  • Sought out training opportunities to enhance customer relationship management abilities and further boost satisfaction scores
  • Consulted with customers about concerns with products or services to resolve problems

Member Service Representative

HGS Service Group
01.2019 - 05.2019
  • Maintained updated knowledge of internal processes and industry best practices to optimize service delivery
  • Maintained accurate and current customer account data with manual form processing and digital information updates
  • Kept administrative records current and accurate to promote efficiency and team effectiveness in all interactions
  • Consulted with customers about their concerns with products or services to resolve problems and drive sales
  • Entered customer interaction details into the software to track requests, document problems, and record solutions offered.

Customer Service Representative

Conduent Call Center
10.2018 - 12.2018
  • Handled 50+ customer inquiries both telephonically and by email while providing customers with product and service information and processing orders, forms and applications
  • Trained two new employees in customer service script recitation, conflict resolution and data entry practices
  • Answered customer telephone calls promptly to avoid on-hold wait times.

Stocker

Walmart
11.2016 - 07.2018
  • Unloaded, sorted, and stocked merchandise according to layout and product placement.
  • Maintained effective team member communication.
  • I greeted customers and directed them to the requested products.
  • Answered customer questions and provided detailed product information.
  • Take inventory or examine merchandise to identify items to be reordered or replenished.
  • Stamp, attach, or change price tags on merchandise, referring to the price list—transport packages to customer’s vehicles.

Dining Facility Manager

U.S. Army Active Duty
01.2000 - 11.2016
  • Developed careers, leadership training, and supervision for 104 personnel and conducted daily preparatory meetings with staff.
  • Coordinated requirements with the Subsistence Supply Management Office, Facility Engineers, and Veterinary Activity.
  • Managed over $12.6 million worth of organizational equipment and assets.
  • Maintained food costs, sanitation standards, product purchasing, and service operations

for food presentation and consistency.

Education

Master of Science - Organizational Leadership Specialization Health Service, Organizational Leadership

Northcentral University
La Jolla, CA
9.2023

Bachelor of Arts - Health Administration, Health Care Administration

University of Arizona
Tucson, AZ
6.2021

Certification |Medical Billing & Coding -

Western Technical College
El Paso, TX
6.2018

Associate of Arts - Food Service Management

Cornell University
Ithaca, NY
6.2005

Skills

  • Medical Terminology and Anatomy
  • CMS Forms
  • Health Care Procedure Coding System
  • Operative Reports
  • Medical Records
  • Evaluation and Management Coding
  • Advance Medical Coding and Auditing
  • Database and Account Management
  • CRM
  • HIPAA Compliances
  • Benefits Verifications
  • Scheduling Medical Appointments
  • Medical Claims Submission
  • Trained in Salesforce
  • Membership Inquiries and Renewals
  • Billing Adjustments and Refunds
  • Issue and Complaint Resolution
  • Pathology and Laboratory Services
  • Sales
  • Insurance Knowledge

Timeline

Provider Claim Support

Centene Corp
05.2023 - Current

Customer Service Specialist

ContinuumRX
03.2020 - 05.2020

Customer Service Specialist

Dial America
09.2019 - 02.2020

Member Service Representative

HGS Service Group
01.2019 - 05.2019

Customer Service Representative

Conduent Call Center
10.2018 - 12.2018

Stocker

Walmart
11.2016 - 07.2018

Dining Facility Manager

U.S. Army Active Duty
01.2000 - 11.2016

Provider Service representative

Centene Corp

Master of Science - Organizational Leadership Specialization Health Service, Organizational Leadership

Northcentral University

Bachelor of Arts - Health Administration, Health Care Administration

University of Arizona

Certification |Medical Billing & Coding -

Western Technical College

Associate of Arts - Food Service Management

Cornell University
Gina Pierce