Gloria Charles
Florence,South Carolina
Summary
Responsible Claims Customer Service Representative that has provided customer support to clients needing assistance with service plans. Researched inquiries, answered questions and offered solutions to resolve issues. Considered valuable team player with great organizational skills.
Overview
30
30
years of professional experience
Work History
Senior Claims Customer Service Representative
Blue Cross Blue Shield of South Carolina
03.1988 - 06.2018
Researches and resolves claim edits and deferrals according to desk procedures
- Provided prompt and accurate responses to all customer inquiries regarding billing matters, medical benefits, claims issues, and account and service information
- Enter claims into CMMS system, applying accurate patient identification, procedure and diagnosis information
- Investigate institutional and professional medical claims for possible adjustment
- Resolved claims disputes, requests for clarification, and appeals in an efficient and timely manner
- Responded to customer requests for products, services, and company information.
- Trained new customer service representatives on best practices, policies and procedures.
Education
Associates Degree - Claims Processing
Columbia College
Columbia, SC12.1987
Skills
- Active Listening
- Critical Thinking
- Delinquent Accounts Monitoring
- Resolving Customer Issues
- Customer Service and Assistance
- Collaborative Environments
- Service Quality
- Verbal and Written Communication
- Lead Generation
- Team Leadership
- Time Management
- Microsoft Office Expertise
Timeline
Senior Claims Customer Service Representative
Blue Cross Blue Shield of South Carolina
03.1988 - 06.2018
Associates Degree - Claims Processing
Columbia College
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