Experienced professional seeking full-time employment to positively impact and inspire the public. Demonstrating a strong work ethic, dependability, and honesty, I bring creative thinking and excel at leading and collaborating within teams. Prioritizing quality and efficiency, I consistently achieve exceptional results.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
Chenega Corporation
10.2024 - Current
Manages multiple tasks lists in accordance with directed timelines
Meets call volume, chat volume, schedule adherence, quality, Veteran appointment and other production standards
Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, and benefit and program questions
In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers
Records preferences, tracks Veteran questions thoroughly in the TriWest's Customer Relationship Management systems and Portal, as well as VA's HSRM systems
Consistently displays professional and courteous service skills to internal and external customers
Accurately resolves VA and provider inquiries with a focus on first call resolution
Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI)
Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information
Documents all communications involving Veteran and provider contacts
Uses critical thinking in problem solving and follows established processes to assure quality program compliance
Consistently meets department productivity and performance metrics to include regular and consistent attendance
Participates in cross training, employee development and flexible assignments to ensure business needs are met
Claims Benefit Specialist
Aetna, a CVS Health Company
01.2023 - 10.2024
Determines covered insurance losses by studying provisions of a policy or certificate
Establishes proof of loss by studying documentation and assembling additional information from outside sources
Documents specific claims by completing and recording forms, reports, logs, and records
Analyzes insurance claims to prevent fraud
Prepares reports by collecting, analyzing, and summarizing information
Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement
Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
Maintains quality customer service by following customer services practices and responding to customer inquiries
Provides legal support by assembling documentation for settlement action
Protects operations by keeping claims information confidential
Maintains a good relationship with insurance departments
Receptionist/Applicant Onboarding Assistant
Helping Hearts
05.2024 - 06.2024
• Applicant Onboarding
• Applicant Interviews
• Applicant background checks/ TB SKIN TEST
• Assist the CEO & Branch Manager With Daily Tasks.
• Applicant Hiring
Greeted clients and visitors, enhancing overall customer service experience. Managed appointment scheduling to ensure smooth daily operations.
Directed phone calls to appropriate departments, improving communication efficiency. Assisted in maintaining clean and organized reception area for a welcoming environment.
Responded to inquiries promptly, providing accurate information to clients. Monitored office supplies inventory, placing orders to maintain stock levels.
Learned and adapted quickly to new technology and software applications. Used critical thinking to break down problems, evaluate solutions and make decisions.
Demonstrated strong organizational and time management skills while managing multiple projects.
Developed and maintained courteous and effective working relationships.
Customer Service Representative
Blue Cross Blue Shield
01.2022 - 12.2022
Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk-in inquiries
Accurately documents inquiries
Initiates or processes adjustments or performs other research as needed to resolve inquiries
Coordinates with other departments to resolve problems
Responds to, researches and/or assists with priority inquiries and special projects as required by management
Provides feedback to management regarding customer problems, questions and needs
Maintains accurate records on complaints and/or other customer comments, and makes recommendations for changes to management
Follows through on complaints until resolved or reports to management as needed
Maintains basic knowledge of quality work instructions and company policies
Assists with process improvements through the recommendation of changes in procedures and techniques discovered during daily operations
Maintains all departmental productivity, quality, and timeliness standards
Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments
Mail Processing Clerk
USPS
09.2020 - 12.2021
Manually sort mail for shipping
CSR - Customer Service Representative
Social Security Administration
10.2019 - 09.2020
Gather facts and evidence to determine if someone is eligible for benefits
Help the public by answering a wide variety of questions both in-person and by telephone
Stocker Associate
Dollar General Distribution
02.2019 - 10.2019
Stock merchandise for the pickers to package, for shipping to all company stores
General Warehouse Associate
Home Depot Distribution
02.2018 - 02.2019
Prepare all freight for shipping
Load & unload trucks
Security Officer/Security Dispatcher
Allied Universal
09.2016 - 02.2018
Provide security services to a professional office building
Security dispatcher at Brookwood Mall
Monitor CCTV
Specimen Accessioner
Labcorp
08.2015 - 08.2016
Prepare specimens for routine lab testing
Pse clerk
USPS
11.2014 - 07.2015
Sorted, organized, & prepared all mail for shipping
Education
High school or equivalent -
Maranathans Academy
Birmingham, AL
12.2008
Skills
Pallet Jack Operation
Food Service Experience
Proficient in Computer Applications
Sales Expertise
Client Support
Effective Communication
Skilled in Microsoft Word Applications
Efficient Calendar Coordination
Staff Guidance Expertise
Courteous Call Management
Deadline-Driven Planning
Assembly Line Operations
Onboarding Coordination
Facilitating Training Sessions
Strategic Evaluation Skills
Calendar Management
Personal Information
Willing To Relocate: Anywhere
Authorized To Work: US for any employer
Timeline
Customer Service Representative
Chenega Corporation
10.2024 - Current
Receptionist/Applicant Onboarding Assistant
Helping Hearts
05.2024 - 06.2024
Claims Benefit Specialist
Aetna, a CVS Health Company
01.2023 - 10.2024
Customer Service Representative
Blue Cross Blue Shield
01.2022 - 12.2022
Mail Processing Clerk
USPS
09.2020 - 12.2021
CSR - Customer Service Representative
Social Security Administration
10.2019 - 09.2020
Stocker Associate
Dollar General Distribution
02.2019 - 10.2019
General Warehouse Associate
Home Depot Distribution
02.2018 - 02.2019
Security Officer/Security Dispatcher
Allied Universal
09.2016 - 02.2018
Specimen Accessioner
Labcorp
08.2015 - 08.2016
Pse clerk
USPS
11.2014 - 07.2015
High school or equivalent -
Maranathans Academy
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