Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kimberly Jones

Little Rock,AR

Summary

Personable and dedicated customer service representative with extensive 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

11
11
years of professional experience
1
1
Certification

Work History

Customer Service Representative

Arkansas Blue Cross Blue Shield
Little Rock, AR
12.2023 - Current
  • Answered customer inquiries and provided accurate information regarding products and services.
  • Provided excellent customer service to resolve customer complaints in a timely manner.
  • Resolved complex problems by working with other departments to provide solutions that meet customer needs.
  • Verified accuracy of customer data entered into the system.
  • Researched relevant policy information to answer customer questions.
  • Conducted follow-up calls to ensure satisfactory resolution of customer issues.
  • Assisted with resolving complex claims or billing disputes in a timely manner.
  • Ensured compliance with company guidelines and regulatory standards when dealing with customers' accounts or policies.
  • Actively participated in training sessions to stay up-to-date on changes in regulations related to insurance policies.
  • Investigated discrepancies between actual charges and expected premiums.

Program Eligibility Specialist

Department of Human Services
Little Rock, AR
05.2022 - 12.2023
  • The Program Eligibility Specialist is responsible for obtaining client information, preparing and monitoring case plans, coordinating services with providers, and preparing information and recommendations. This position is governed by state and federal laws, and agency/institution policy.
  • Reviews referrals for services and interviews applicants and/or family members to explain eligibility requirements, form completion requirements, and community resources.
  • Requests information to determine client eligibility or needs and forwards requests for approval to appropriate staff, in accordance with established procedures.
  • Provides information regarding resources, assistance, and services available to applicants and may visit with clients and family members in their homes to determine client needs and provide family and/or parent behavior modification counseling.
  • Schedules initial intake conference with client and/or family members, following eligibility determination, to obtain written and oral information regarding psychiatric, psychological, medical background, financial status, and other previous professional recommendations.
  • Evaluates requests and professional findings, in accordance with policies and procedures, and initiates procedures to grant, modify, deny, or terminate eligibility for assistance, with recommendations and options for services, referring client to alternative sources, or preparing additional requests for evaluation and assistance.
  • Writes individualized plan of care and contacts participating private and public service providers for assistance. Interprets policy and ensures compliance with state and federal laws, regulations, legal mandates, action plans, and policies. May serve as a liaison to other divisions and agencies to develop policies and procedures for community-based programs. Performs other duties as assigned.

Administrative Assistant III

Arkansas Department of Human Services
Little Rock, AR
01.2022 - 05.2022
  • Reviews incoming legal cases and documents for completeness, accuracy, and compliance, and prepares a variety of legal pleadings for review by the attorney.
  • Processes all documents for court and legal action. Issues and processes subpoenas for witnesses for court hearings or mediation, and processes statements.
  • Maintains a schedule to monitor service of process, return of service, and other time-sensitive documents.
  • Schedules hearings, sets cases for court, enters cases into docket book for court, and assembles all necessary case materials for attorney.
  • Prepares answers to motions and orders correctly and timely, and routes orders to judge or opposing counsel when approved by the attorney. Creates, opens, and maintains confidential case files.
  • Updates narrative as case progresses and enters case information into appropriate database. Prepares, faxes, copies, files, and mails case information and documents, as needed, in a timely manner, following established procedures and protocol.
  • Assists customers on case status, either in person or on the telephone, and provides general information or routine responses. Transcribes hearings. Copies, files, and processes documents following standardized procedures.
  • Initiates telephone calls to the respondent, defendant, attorney's office, and others directly involved in the case.
  • Conducts research and investigations as assigned and reports findings to attorney or judge in written or verbal narrative. Performs duties as assigned.

Patient Access Representative

Conifer Healthcare Solutions
Little Rock, AR
06.2017 - 12.2021
  • Register patients for ER, Outpatient, and Cardiac Cath Lab while working closely with doctors and staff for procedures, executing admissions, and discharge procedures.
  • Post cash/check receipts (co-pays) and miscellaneous monies received.
  • Assist with insurance verification and patient liability, acquire prior authorizations and doctors' orders.
  • Demonstrates good judgment in respecting the confidentiality of patient and employee information. Scan patient documents.
  • Greeted patients and visitors in a courteous and professional manner.
  • Verified insurance coverage for services provided by the facility.
  • Collected co-pays and other payments from patients at time of service.
  • Ensured accuracy of all data entered into computer system.
  • Scanned documents into electronic medical records system.

Salon Owner/Operator

Nailgirl Studio
Little Rock, ARkansas
11.2019 - 10.2021
  • Maintained salon finances, including budgeting, payroll and bookkeeping.
  • Organized and scheduled appointments for clients using software systems.
  • Created marketing strategies to increase clientele and expand the business.
  • Provided excellent customer service to ensure repeat business from satisfied clients.
  • Ordered supplies and equipment needed for daily operations.
  • Ensured that all safety protocols were followed in the salon at all times.
  • Promoted special offers through social media platforms to attract new customers.
  • Resolved customer complaints quickly and efficiently while maintaining professionalism.

Medical Receptionist

Little Rock Dermatology Clinic
Little Rock, AR
08.2013 - 08.2016
  • Greeted and checked in patients, updating patient information in computer system.
  • Verified insurance coverage for appointments and collected co-payments as required.
  • Scheduled patient appointments, verifying accuracy of appointment times with providers.
  • Answered incoming calls, responding to inquiries from patients and other medical offices.
  • Prepared charts for new patients, ensuring all necessary forms were completed correctly.
  • Processed referrals for specialist care when requested by physicians or patients.
  • Called patients to confirm scheduled appointments and obtain additional details.

Education

High School Diploma -

JA Fair High School
Little Rock, AR
06-1989

Skills

  • Scheduling
  • Complaint resolution
  • Account updating
  • Exchange coordination
  • Coordination
  • Skype
  • Call center experience
  • Documentation
  • Prioritization
  • Filing
  • Positive and professional
  • Excellent verbal communication
  • Customer Service-Oriented
  • Detail Oriented

Certification

  • Mental First Aider Certificate

Timeline

Customer Service Representative

Arkansas Blue Cross Blue Shield
12.2023 - Current

Program Eligibility Specialist

Department of Human Services
05.2022 - 12.2023

Administrative Assistant III

Arkansas Department of Human Services
01.2022 - 05.2022

Salon Owner/Operator

Nailgirl Studio
11.2019 - 10.2021

Patient Access Representative

Conifer Healthcare Solutions
06.2017 - 12.2021

Medical Receptionist

Little Rock Dermatology Clinic
08.2013 - 08.2016

High School Diploma -

JA Fair High School

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Kimberly Jones