Kelsey Pike
Greeneville,Tennessee
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Compassionate and detail oriented with experience from in-home caregiving to processing claims.
Overview
4
4
years of professional experience
Work History
Claims Representative
Advanced Call Center Technologies LLC
Johnson City, TN
08.2022 - 12.2022
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Reviewed documentation and accounts to gain full picture.
- Utilized claims management software to track claims progress and maintain organized documentation.
- Organized information by using spreadsheets, databases or word processing applications.
Customer Service Representative
Advanced Call Center Technologies LLC
Johnson City, TN
04.2022 - 12.2022
- Developed positive relationships with customers through friendly interactions.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Maintained a high level of professionalism when dealing with difficult customers.
- Developed strong relationships with customers by providing personalized assistance and support.
- Answered customer inquiries and provided accurate information regarding products and services.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Answered inbound calls, chats and emails to facilitate customer service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Used approved scripts to de-escalate angry customers during telephone interactions.
- Utilized job-related software to prepare change of address records and issue service discontinuance orders.
- Adjusted bills and refunded money to resolve customers' service or billing complaints.
- Developed effective working relationships with team members across multiple departments.
- Maintained records of customer interactions, transactions, comments and complaints.
- Maintained accurate records of customer interactions for future reference.
- Attended regular training sessions on updates and changes within the industry or organization.
- Utilized knowledge base to answer inquiries from customers quickly and effectively.
- Participated in daily huddles with team members in order to discuss common goals and objectives.
- Adhered to all applicable laws, regulations, policies, and procedures relating to financial services.
- Monitored account activities for suspicious patterns that could indicate fraudulent activity.
- Prepared daily activity reports for management review.
- Identified potential fraud cases and reported them to the supervisor.
- Processed wire transfers in accordance with established policies and procedures.
Caregiver
Rescare Homecare
Greeneville, TN
05.2021 - 04.2022
- Performed light housekeeping tasks related to the client's care such as laundry and changing linens.
- Assured proper nutrition by preparing meals, grocery shopping and monitoring food consumption levels.
- Maintained accurate records of services provided, changes in client condition, medications administered and other pertinent information.
- Assisted elderly clients with activities of daily living, such as bathing, dressing and grooming.
- Provided emotional support to clients during difficult times.
- Coordinated transportation services for clients when necessary.
- Administered prescribed medications on a timely basis following care plan instructions.
- Respected the rights of each individual client while maintaining confidentiality of all personal information.
- Educated families about available resources for home health care services in the local community.
- Ensured compliance with all applicable laws, regulations and standards governing home health care services.
- Followed care plan and directions to administer medications.
- Followed safe lifting and transferring techniques to transport residents.
- Monitored health and well-being of clients and reported significant health changes.
- Built strong and trusting rapport with clients and loved ones.
- Managed calendars including scheduling appointments and events.
Crew Member
McDonald's
Greeneville, TN
01.2020 - 04.2021
- Monitored quality of food served to ensure it met company standards for presentation and temperature.
- Resolved customer complaints in a professional manner.
- Greeted customers upon arrival, provided menus and answered questions regarding menu items.
- Informed customers about daily specials in an engaging manner.
- Adhered to health department regulations regarding food handling procedures.
- Completed opening and closing tasks such as setting up workstations, cleaning surfaces and restocking supplies.
- Provided excellent customer service to maintain a positive atmosphere for guests.
- Processed takeout orders quickly to ensure timely delivery of meals.
- Followed all safety guidelines while operating equipment such as slicers, fryers and ovens.
- Answered phone calls promptly to provide accurate information about menu items or prices.
- Kept up-to-date knowledge of store policies regarding payments, returns and exchanges.
- Took orders from patrons and input selections into store computer system.
- Presented orders to guests within anticipated service times.
- Interacted pleasantly with guests to deliver quality customer service.
Retail Sales Associate
Marshalls
Greeneville, TN
03.2019 - 11.2019
- Handled customer complaints in a professional manner.
- Assisted customers with finding the right product for their needs.
- Promoted special offers and discounts to encourage additional purchases.
- Maintained a clean work environment by sweeping, dusting, vacuuming and mopping floors.
- Inspected purchased items for defects before handing them over to customers.
- Demonstrated knowledge of store products and services.
- Provided product information and answered customer questions.
- Performed cashier duties such as ringing up sales, processing payments, and issuing receipts.
- Kept informed about new products arriving at the store on a regular basis.
- Stocked shelves with merchandise according to company standards.
- Operated point-of-sale systems accurately to process payments from customers.
- Completed transactions in an efficient manner while providing excellent customer service.
- Processed returned merchandise according to company policies.
- Handled price checks, merchandise transfers and fitting room returns to keep store orderly and efficient.
- Cleaned shelves, counters and tables to maintain organized store.
Education
High School Diploma -
Chuckey Doak High School
Afton, TN05-2021
Skills
- Team Collaboration
- Data Analysis
- Conflict Resolution
- Flexible Schedule
- Policy understanding
- File Management
- Data Entry
- Dependable and Responsible
- PPE Usage
- Professionalism
- Time management abilities
- Payment Processing
- Written and oral communication skills
- Meeting deadlines
- Building rapport
- Positive and professional
- Incident Reporting
- Documentation
- Progress Documentation
- HIPAA Compliance
- Daily living assistance
- Multitasking and Organization
Affiliations
I enjoy reading and having day outings with my husband and daughter. Cooking and baking have to be my most captivating hobby outside of being a mom!
Accomplishments
- Recognized by corporate and admin at Rescare for my ability to multitask and still provide care to elderly/disabled people- exceeding standards. Commended for working 6 and 7 day weeks at 10-14 hours a day when staffing was low to ensure client's received the assistance they needed.
- My supervisor and operations manager put me up for a supervisor position within Advanced Call Center Technologies within 6 months of employment.
About Me!
- I went to online schooling in 2019 to care for my grandmother. While caring for her, I was able to complete high-school virtually while maintaining my GPA and working part time at night. Work ethic has always been an important part of who I am. My work thrives in settings with the opportunity to progress and build rapport within the company. I have stayed home with my daughter since December of 2022 and am ready to step back into the workforce.
Timeline
Claims Representative
Advanced Call Center Technologies LLC
08.2022 - 12.2022
Customer Service Representative
Advanced Call Center Technologies LLC
04.2022 - 12.2022
Caregiver
Rescare Homecare
05.2021 - 04.2022
Crew Member
McDonald's
01.2020 - 04.2021
Retail Sales Associate
Marshalls
03.2019 - 11.2019
High School Diploma -
Chuckey Doak High School
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