Ginger Baker
Wise,VA
Summary
Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
32
32
years of professional experience
1
1
Certification
Work History
CoverVA Service Specialist
Maximus Health Services CoverVA Project
Wise, VA
10.2023 - 04.2024
- Accepted inbound calls from individuals seeking Virginia Medicaid seeking status of their applications
- Identity verified each caller by first and last name, address, date of birth, and social security number, or alien identification number when applicable
- Used Virginia state Medicaid system MMIS, MES and VaCMS for identification verification, entering new applications, renewal applications, and reporting any changes to case information provided by the client
- Entered and linked caller accounts from CoverVa with the Virginia State Medicaid systems in ConnectionPoint CRM system
- Followed scripting within Panviva system verbatim per Virginia Medicaid guidelines when answering each call
- Entered all information required for a new application for Virginia residents for state medical assistance
- Entered renewal applications and updated applications for income changes, address changes, martial status, people moving in and out of the home
- Worked with 7 State and Federal systems verifying information given by the caller
- Researched client case information for eligibility status updates, documentation requirements requested by LDSS (Local Department of Social Services), reasoning for denial or closed case statuses
- Filed appeals and complaints as requested by clients
- Escalated emergency cases for faster determination due to pregnancy, health conditions, medication necessity, and medically necessary applications submitted
- Observed HIPPA Rules, Regulations, and Guidelines for every call
- Answered any questions within the scope of the job description allowed for eligibility
- Used outbound call procedures for any applications taken requiring further information, errors, or updates required before submittal
- Transferred callers to appropriate Managed Care Organization (MCO) such as Anthem, United Healthcare, Optima
- Magellan, and Aetna member helpline when unable to assist the caller enrolled in a MCO
- Passed Virginia State examinations on Internet Security, HIPPA rules and regulations, and CoverVA and State Medicaid policies
- Accessed ConnectionPoint, VACMS, MMIS, MES, USPS address verification website, Panviva, Genesys, Microsoft Teams, Zoom daily when assisting callers.
TRICARE Beneficiary Support Representative
Veterans Government Services/HUMANA MILITARY
Alexandria, VA
05.2023 - 08.2023
- Took inbound calls from military service members and family members regarding health insurance (Tricare)
- Had working knowledge of all types of plans for all seven (7) branches of the Armed Forces
- Had working knowledge of the ranking levels of the beneficiary to appropriately access information regarding the specific plans for each service member
- Continued education on the changing programs offered and benefits for each individual plan specific to the branch of service
- Researched eligibility requirements for beneficiaries and the family members once leaving Active Duty status
- Stayed up to date on the programs available to the Service members under their individual plan assignments
- Continued education regarding Military Based Facilities and providers or Civilian facilities and providers
- Gave updated claim information according to the account information
- Transferred calls to specific departments for enrollment, dental, pharmacy, mental health related calls out of my scope of ability
- Took payments for monthly premiums
- Gave information regarding co-pays, deductibles, point-of-service payment options, and reimbursements options if required
- Reviewed information to determine eligibility of Service members and their family members to determine which medical insurance coverage programs within Tricare they were eligible and qualified for
- Gave the appropriate information to each beneficiary regarding the programs they qualified to participate in for health insurance coverage.
Answering Service Agent
Answerphone Of America
Statesville, NC
02.2023 - 05.2023
- Took inbound calls from several different types of businesses using the directions set forth by each for after hours calls, weekend and holiday calls, or during business hours when the businesses phone lines are busy and staff unable to assist the customers
- Gave any allowed information to customer and clients, all set forth by each individual business
- Collected information for on call technician visits for estimations and emergencies after business hours, weekends, and holidays.
CSR - Customer Service Representative
MODIVCARE
South Portland, ME
12.2018 - 09.2022
- Assisted customers with a warm and professional attitude
- Kept records of customer complaints
- Handled emails, inbound calls, and outbound calls
- Booked appointments
- Managed customer accounts
- Scheduled non-emergency medical transportation to and from medical appointments
- Explained to clients the transportation benefits provided by their individual insurance plan
- Verified insurance benefits, obtained prior authorizations
- Worked with transportation providers ensuring transportation was provided.
Customer Service Representative
Luttrell Staffing Group/Modivcare(formerly Logisticare)
Norton, VA
12.2018 - 06.2020
- Utilized organization's computer system to look up and record information concerning member accounts
- Addressed customer concerns and complaints, entering all information into LCAD system, saving the information provided, and generated Identification number per each incident, that was given to the caller for their records
- Attempting to resolve issues quickly and efficiently
- Completed and processed reservation records with attention to detail to ensure accurate entry of important data in company's CRM LCAD Scheduling Software
- Answered inbound calls to assist customers with various needs and questions regarding transportation services provided through each individuals Insurance benefit package
- Implemented best practices in fostering exceptional customer care support and satisfaction
- Exceeded requirements in providing services to customers at all times
- De-escalated customer complaints using friendly customer service satisfaction techniques
- Routed inquiries or escalated calls outside area of expertise to appropriate department or employee
- Documented detailed notes in LCAD system to track customer interactions, reservations, and complaint tickets
- Advised customers on status of transportation reservation and arrangement for pickup and delivery to and from medical appointments
- Utilized CRM tools to record, track, and maintain reservation records
- Provided policy and service information strictly following HIPPA regulations
- Strictly used verbatim scripting provided by each individual Insurance Company.
Server/Hostess/Cashier
Huddle House
Wise, VA
01.2014 - 10.2016
- Served customers within an assigned section of tables, divided by the supervisor, and assigned to wait staff at the beginning of each shift
- Entered order specifications into computer system, printing each ticket for kitchen staff to prepare orders, and for the check status at the end of the dining time of the customer
- Gave exceptional service and attention to all patrons in assigned and unassigned areas as needed or for any customer request
- Prepared food as needed giving assistance to kitchen staff when the restaurant was extremely busy
- Cleaned both dining room area as well as the kitchen and waitress station areas of the restaurant as was needed
- Was only employee, other than store manager, that received Serv-Safe certification and Food Handling Certifications at this location.
Answering Service Operator
TELEMED INC
Wise, VA
03.2006 - 11.2009
- Answered inbound calls in an extremely high call volume call center
- Used medical triage to determine importance and medical care needs of each incoming call
- Took detailed messages for on call physicians, on call medical personnel, and medical offices
- Delivered emergency call, messages, and sent pages to the necessary medical professional in a timely and efficient and accurate manner
- Took all required information specified by each individual physician for consultations requested by hospitals and other medical personnel
- Showed Empathy, Patience, and understanding for each caller.
Customer Service Representative
Sykes Enterprises, Incorporated
Wise, VA
10.2001 - 07.2004
- Took inbound customer calls for DSL computer services
- Provided customers and end users with product and technical support
- Maintained technical proficiency in assigned products and platforms
- Communicated with team members and team leader, as well as other staff and supervisors as needed and or required to perform work to the best possible ability
- Maintained paperwork and account notations for each individual call
- Met performance, productivity, and quality expectations set both personally and by the company as well
- Resolved customer issues using steps provided by the client information system and troubleshooting scripting
- Collected and documented all information regarding each call taken, ensuring account information and reason for the call was detailed for quality and training purposes.
Administrative Assistant/Legal Secretary
Goss, Greene, Jimenez, and Ebbert Law Practice
Indianapolis, IN
02.1995 - 09.2000
- Answered multiple line telephone system, took messages, scheduled meetings and appointments for three attorneys within the office
- Distributed mail to each department throughout the Corporate Offices daily
- Scheduled travel arrangements by booking airline flights, hotel reservations, and reservations for rental car service
- Monitored attorneys calendar scheduling appointments for meetings, conferences, or travel arrangements
- Handled all client records and correspondence within the office
- Answered phones promptly to eliminate hold times or missed calls
- Performed research and collected data and information requested by attorneys
- Edited proposals, contracts, transmittals and any documentation requested to meet time sensitive deadlines
- Supported various administrative duties throughout the office including proofreading, transcribing, and invoicing.
Clerical Support/Receptionist
Kelly Services//General Motors Corporation; GMAC Financing Co.; Kroger Floral Division(Main Store Front); USA Group Student Financial Aid Services
Anderson, IN
06.1992 - 08.1993
- Worked as temporary employee for businesses in need of additional assistance for a period of time
- Served as clerical assistant or office assistant for Companies within Castleton, Fishers, Indiana Area
- Data entry of Student financial Aid applications for FAFSA and Pell Grant Applications
- Took orders over telephone, through mail, fax, or in store orders for floral arrangements, for events, weddings, special functions, or person to person gifting
- Assigned orders to Floral Decoration Staff for order completions
- Arranged deliveries for all orders that was serviced within the Corporate Store Front Location
- Proofread GMAC Financial Documents to ensure completion of contract terms
- Distributed Mail to each department and gathered outgoing mail for following day
- Sorted, Weighed, and using USPS Postage metering postage machine, packaged and mailed all outgoing mail for each department as instructed
- Ordered all office supplies for General Motors and Delco Remy General Managers Offices
- Answered Multi-line phone system and transferred calls to department or individual within Location offices
- Any clerical, filing, faxing, documenting requests from 3 General Supervisors and approximately 20 other managers of various departments within the office location
- Made photo copies of all material that was distributed through out the Corporate Office
- Ensured all Department Managers and other specified employees received all specifications, blue prints, legal documents, as well as any interoffice memorandums or Company letterhead per request of General Management Officials.
Education
Associates of Applied Science - Medical Billing and Coding/Medical
University of Phoenix-Online Campus
05.2024
Pendleton Heights High School
06.1992
Skills
- HIPAA Rules and Regulations/ Patient Records Confidentiality Procedures
- Highly Motivated/Self Discipline/Delegation/Commitment
- Insurance verification/Prior Authorization
- Medical terminology
- Scheduling/Reservations/CRM Software
- Active Listening/Attentiveness
- Written Communication/Proofreading
- Conflict Management/Problem Solving/Critical Thinking
- Adaptability/Empathy/Patience
- Microsoft Word / Outlook / Excel / Windows
- Organizational skills / Time Management
- Medical/Legal Office Experience
- Customer service/Customer Support
- Call Center(15years)
- Inbound Calling
- Data Entry
- Scheduling
- Route Management
- Computer/office Equipment Proficiency
- Medical terminology
- Call Center Operations
- Technical Support
- CRM Software
- Professional telephone demeanor
- Travel Planning
- De-Escalation Techniques
- Calendaring
- Tactful and diplomatic
- High-energy attitude
- Positive and professional
- Prioritization
- Customer Relationship Management (CRM)
- Information Security
- Call Management
- Account updating
Certification
Driver's License
Relocation
- Wise County, VA, Tri-Cities, TN
- Surrounding areas, Wise County, VA, Tri-Cities, TN
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
CoverVA Service Specialist
Maximus Health Services CoverVA Project
10.2023 - 04.2024
TRICARE Beneficiary Support Representative
Veterans Government Services/HUMANA MILITARY
05.2023 - 08.2023
Answering Service Agent
Answerphone Of America
02.2023 - 05.2023
CSR - Customer Service Representative
MODIVCARE
12.2018 - 09.2022
Customer Service Representative
Luttrell Staffing Group/Modivcare(formerly Logisticare)
12.2018 - 06.2020
Server/Hostess/Cashier
Huddle House
01.2014 - 10.2016
Answering Service Operator
TELEMED INC
03.2006 - 11.2009
Customer Service Representative
Sykes Enterprises, Incorporated
10.2001 - 07.2004
Administrative Assistant/Legal Secretary
Goss, Greene, Jimenez, and Ebbert Law Practice
02.1995 - 09.2000
Clerical Support/Receptionist
Kelly Services//General Motors Corporation; GMAC Financing Co.; Kroger Floral Division(Main Store Front); USA Group Student Financial Aid Services
06.1992 - 08.1993
Associates of Applied Science - Medical Billing and Coding/Medical
University of Phoenix-Online Campus
Pendleton Heights High School
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