Kimberly Howard
Chicago,Illinois
Summary
Personable and dedicated customer service representative with extensive 18+ years experience in industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
20
20
years of professional experience
Work History
Customer Service Specialist
Evolent Health
2023.03 - Current
- Answer and manage inbound inquiries from customers in a prompt, courteous manner while documenting relevant information in a clear and concise manner in computer systems
- Ask appropriate questions and listen actively to identify specific questions or issues to provide appropriate response and type of assistance the customer needs
- Reply and handle inquiries via telephone and other communication channels, regarding health plan benefits and claims, eligibility, medical and other healthcare procedures, billing and payments and other related topics
- Conduct out-bound and/or return calls to customers as necessary
- Analyze and own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the customer, providing accurate and complete information and solutions
- Communicate and partner with customers tactfully and empathetically to resolve issues, using clear language translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can comprehend and act upon
- Handle and process customer complaints/ grievances while applying appropriate conflict management skills to de-escalate potentially stressful situations
- Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction and attendance
- Adhere to all applicable department, organization and/or regulatory policies and procedures
- Read, comprehend and verbalize processes and procedures of the organization and of health insurance coverage
Referral Specialist I
Anthem Inc
2017.07 - 2022.12
- Initiates and manages clinical referrals for pre-authorization
- Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources
- Reviews referrals for completeness and follows up for additional information if necessary
- Assigns escalated referrals to staff as appropriate
- Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures
- Responds to inbound calls initiating exam requests following established processes, meets quality and production standards
- Contacts physician offices as needed to obtain demographic information or related data
- Enters referrals, documents communications and actions in system
- Attained my first 5 100% Quality Month for October 2017
Customer Service Advocate
Optum Rx
2016.01 - 2016.11
- Manage prescription drug benefits for company clients, handle customer inquiries through phone and email contact regarding billing questions and service requests
- Calm angry callers, repair trust, locate resources for problem resolution and design best-option solutions
- Interface daily with internal partners in financial services, benefits, training, operations and management
- Averaged 95-98 Quality Average
- MSE (Customer Service Email) Team
- Completed voluntary customer service training to learn ways to promote customer satisfaction and improve productivity
Member Services Representative
Catamaran LLC
2014.06 - 2015.12
- Manage prescription drug benefits for company clients, handle customer inquiries through phone and email contact regarding billing questions and service requests
- Calm angry callers, repair trust, locate resources for problem resolution and design best-option solutions
- Interface daily with internal partners in financial services, benefits, training, operations and management
- Averaged a 95% average for the 2014 plan year
- Appointed to MSE (Member Services Email) Team
- Completed voluntary customer service training to learn ways to promote customer satisfaction and improve productivity
Customer Service Representative
Aerotek Professional Services
2013.09 - 2014.06
- Manage prescription drug benefits for company clients, handle customer inquiries through phone and email contact regarding billing questions and service requests
- Calm angry callers, repair trust, locate resources for problem resolution and design best-option solutions
- Interface daily with internal partners in financial services, benefits, training, operations and management
- Appointed to MSE (Member Services Email) Team
- Completed voluntary customer service training to learn ways to promote customer satisfaction and improve productivity
Customer Service Scheduler
Northbridge Staffing Services
2013.06 - 2013.07
- Took inbound calls for customer (Moderate to Large contract construction, public and private events) orders for fencing and portable toilet rentals
Quality Assurance Assistant
Office Team
2012.09 - 2013.01
- I provided assistance to the on site Quality Analyst
- I was responsible for client file creation, data entry, placing outbound calls to brokers for appointment confirmation
Customer Account Executive
Comcast Communications
2011.08 - 2012.08
- Taking 50-70 inbound calls daily regarding billing, sales and video repair inquiries
- Processing payments and re-enforcing policy and value for company products and promotions with our customers
- Recognized for superior performance (Voice of the Customer)
- Averaged 95%-100% monthly quality rating
- Completed voluntary customer service training to promote customer satisfaction and improve productivity
Customer Service Representative
The Pampered Chef
2008.03 - 2011.02
- Handle customer inquiries, complaints, billing questions and service requests
- Calm angry callers, repair trust, locate resources for problem resolution and design best-option solutions
- Interface daily with internal partners in financial services, customer career solutions, training, operations and management
- Recognized for superior performance and dedicated service commitment through induction into The Pampered Chef Quality Key Club
- Averaging 95%-100% percentile for quality
- Helped company attain the highest customer service ratings -- earned impressive marks in all categories including communication skills, listening skills, problem resolution and politeness
- Commended for initiative, enthusiasm, tenacity, persuasiveness, intense customer focus and dependability in performance evaluations
- Completed voluntary customer service training to promote customer satisfaction and improve productivity
Customer Service Representative
Venturi Staffing Partners
2007.09 - 2008.03
- Handled incoming calls from Jewel/Albertson's employees/policyholders holders, responding to inquiries, resolving problems
- Completed enrollment and provided quotes for medical, dental, vision and life insurance
- Handled incoming calls (December 2007 - March 2008) for company field consultants with the Pampered Chef
- Managed a high-volume workload within a deadline-driven environment
- Resolved an average of 350 inquiries in any given week and consistently met performance benchmarks in all areas (speed, accuracy, volume)
- Managed to secure a permanent position with the Pampered Chef as a result of providing them with top-quality service
Customer Service Associate
Aon Hewitt
2005.09 - 2007.08
- I systematically handled incoming calls from UPS employee/ policyholders, responding to inquiries, resolving problems and correcting policy errors
- I completed enrollment and provided quotes for medical, dental, vision, life insurance and oversaw payment collection for COBRA and retirement accounts for UPS employees
- Maintained an impressive 95% quality rating in an extremely high performance call center environment
- Governed individual assigned projects while keeping current with regular call center responsibilities
- Provided suggestions on how to streamline current system design so the client team could focus on giving better, faster customer care to clients and employees
Education
Diploma - College Preparatory Studies
Queen of Peace High School
Burbank, Illinois01.1992
Skills
- Customer Service
- Call Center Service Operations
- Complaint Handling
- Dispute Resolution
- Data Entry
- Records Management
- Multi Line Phone Use
- Billing
- Technical Support
- AS400
- Navigator Systems
- MS Word
- Excel
- Lotus Notes
- Oracle
- Pre-authorization processing
- Insurance verification
- Referral management
- Data entry
- Customer service
- Conflict resolution
- Active listening
- Problem solving
- Attention to detail
- Time management
- Documentation skills
- Effective communication
- Interpersonal skills
- Clinical documentation improvement
- Private insurance
- Patient confidentiality compliance
- Insurance procedures
- Effective communication skills
- Authorizations
- Professionalism and ethics
- Pharmacy benefit management
- Benefit coverage
- HIPAA compliance
- Prior authorization process
- Medical terminology
- Utilization review experience
- Medical terminology knowledge
- Provider relations
- Healthcare regulations
- Cultural sensitivity
- Documentation and paperwork
- Interpersonal communication
- Multitasking Abilities
- Communication skills
- Relationship building
- Problem-solving abilities
- Organizational skills
- Report writing
Additional Information
10-25 miles from permanent residence, True, True
Personal Information
- Total Experience: 16+ YEARS EXPERIENCE IN CALL CENTER SETTINGS
- Title: SERVICE REPRESENTATIVE
Timeline
Customer Service Specialist
Evolent Health
2023.03 - Current
Referral Specialist I
Anthem Inc
2017.07 - 2022.12
Customer Service Advocate
Optum Rx
2016.01 - 2016.11
Member Services Representative
Catamaran LLC
2014.06 - 2015.12
Customer Service Representative
Aerotek Professional Services
2013.09 - 2014.06
Customer Service Scheduler
Northbridge Staffing Services
2013.06 - 2013.07
Quality Assurance Assistant
Office Team
2012.09 - 2013.01
Customer Account Executive
Comcast Communications
2011.08 - 2012.08
Customer Service Representative
The Pampered Chef
2008.03 - 2011.02
Customer Service Representative
Venturi Staffing Partners
2007.09 - 2008.03
Customer Service Associate
Aon Hewitt
2005.09 - 2007.08
Diploma - College Preparatory Studies
Queen of Peace High School