JEANETTE OGILVIE
JONESBORO,GA
Summary
Experienced service professional with a strong track record in managing projects, operations, and deadlines for timely delivery. Well-regarded for leadership and analytical skills, proficient in implementing cross-functional and multi-tasking concepts. Demonstrates exceptional customer service through effective listening and problem-solving skills.
Overview
27
27
years of professional experience
Work History
INBOUND CUSTOMER SERVICE REP.
CAPITAL RX PBM
10.2022 - Current
- Managed pharmacy benefits for Medicare, Medicaid, and commercial accounts.
- Specialized in reviewing medical documentation for authorization requests.
- Enhanced comprehensive benefits coverage.
- Processed lost, stolen and vacation overrides efficiently.
INBOUND CONTACT REP 2
HUMANA INSURANCE COMPANY
09.2021 - 10.2022
- Provided targeted guidance on various individual Medicare insurance solutions.
- Managed high volume of incoming calls from remote location.
- Facilitated side-by-side rep training through direct shadowing.
- Managed pharmacy overrides and prior authorization requests.
- Managed end-to-end handling of Medicare Part A & B claims.
- Managed Benefits-SMAPD, Duals, SNP, PPO, HIDE/FIDE & PDP Policies.
- Oversaw policy administration including enrollment, reinstatement, and disenrollment.
RESOURCE DEVELOPMENT SPECIALIST
DEPT. OF FAMILY & CHILDREN SERVICES
04.2014 - 12.2018
- Conducted thorough inspections of foster care homes.
- Conducted instructional workshops for prospective foster caregivers.
- Conducted yearly assessment of Foster homes.
- Performed quarterly reviews on conditions in foster homes.
- Managed invoicing and payments related to foster care programs.
CUSTOMER SRV AGENT
PHILLIPS HEALTHCARE
03.2013 - 01.2014
- Delivered exceptional customer service in high-volume call center environments.
- Ensured efficient handling of a minimum of 70 calls each shift.
- Reviewed medical equipment claims efficiently.
- Coordinated dispatch of technicians to multiple locations.
CUSTOMER SRV AGENT
DELTA AIRLINES
01.2006 - 12.2012
- Coordinated timely aircraft loading.
- Coordinated bag assistance services for regional passengers.
- Managed efficient transfer of cargo during aircraft loading and unloading.
- Guided incoming aircraft to their designated gates.
RESERVATIONS SPECIALIST
AIRTRAN AIRWAYS
11.2004 - 12.2006
- Handled incoming calls on a complex multi-line system.
- Coordinated and modified client reservations.
- Established customer credit lines and set up credit accounts
COORDINATION OF BENEFITS REP.
GHI INC
01.2001 - 08.2004
- Responsible for coordinating medical benefits for Medicare eligible beneficiaries.
- Handled at minimum 70 incoming phone inquiries per shift.
- Updated records to reflect primary payer information to ensure proper payment of claims.
- Resolved claims payment issues for providers, attorneys and other insurance carriers.
- Ensured 100% regulatory compliance with the Centers for Medicare and Medicaid Services (CMS) including The Health Insurance and Portability and Accountability Act (HIPAA).
- Created and maintained records to reflect auto no fault, liability and workers compensation cases for attorneys and beneficiaries.
- Assisted employers with government implemented data match questionnaires.
CARE SPECIALIST
SUNY DOWNSTATE MED CTR
03.2000 - 01.2001
- Maintained Medical records
- Processed Medical claims
- Handled all billing & collections
- Processed third party liability claims
PUBLIC HEALTH SANITARIAN
NYC DEPT. OF HELTH
01.1998 - 02.2000
- Conducted restaurant and school kitchen inspections.
- Issued written violations
- Conducted building window guard inspections.
- Attended administrative tribunals.
Education
B.S. - BIOLOGY
LINCOLN UNIVERSITY
OXFORD, PA12.1995
Skills
- Microsoft Office
- Sales force
- Prompt PA
- RX Nova
- RX Connect Pro
- Cas client systems
- Mac & PC Systems
- Solutran
Timeline
INBOUND CUSTOMER SERVICE REP.
CAPITAL RX PBM
10.2022 - Current
INBOUND CONTACT REP 2
HUMANA INSURANCE COMPANY
09.2021 - 10.2022
RESOURCE DEVELOPMENT SPECIALIST
DEPT. OF FAMILY & CHILDREN SERVICES
04.2014 - 12.2018
CUSTOMER SRV AGENT
PHILLIPS HEALTHCARE
03.2013 - 01.2014
CUSTOMER SRV AGENT
DELTA AIRLINES
01.2006 - 12.2012
RESERVATIONS SPECIALIST
AIRTRAN AIRWAYS
11.2004 - 12.2006
COORDINATION OF BENEFITS REP.
GHI INC
01.2001 - 08.2004
CARE SPECIALIST
SUNY DOWNSTATE MED CTR
03.2000 - 01.2001
PUBLIC HEALTH SANITARIAN
NYC DEPT. OF HELTH
01.1998 - 02.2000
B.S. - BIOLOGY
LINCOLN UNIVERSITY
Similar Profiles
Amanda FetauiAmanda Fetaui
Remote Pharmacy Customer Service Representative at Capital RxRemote Pharmacy Customer Service Representative at Capital Rx
Simone Moultrie-AdamsSimone Moultrie-Adams
Customer Service Representative at Capital RxCustomer Service Representative at Capital Rx
Shianna PetersShianna Peters
Customer Care Representative III at Capital RxCustomer Care Representative III at Capital Rx
KIMBERLY MILLWEEKIMBERLY MILLWEE
Customer Service Lead at Better Business BureauCustomer Service Lead at Better Business Bureau
Kenneth BrownKenneth Brown
Barber at KaeGoCrazy LLCBarber at KaeGoCrazy LLC