Kiyana Turner
Phoenix
Summary
Experienced customer service representative skilled in enhancing client relationships and ensuring customer satisfaction. Recognized for a positive demeanor and ability to work collaboratively within teams. Committed to driving company success through effective communication and partnership development. Results-driven with a focus on business growth and client engagement.
Overview
15
15
years of professional experience
Work History
Senior Customer Advocate Claims Specialist
Blue Cross Blue Shield of Arizona
Phoenix
04.2023 - Current
- Answered a diverse, high volume of health insurance-related customer calls and correspondence daily, ensuring timely and accurate responses.
- Identified, researched, processed, resolved, and responded to customer inquiries and correspondence via telephone, written communication, and in person, enhancing customer satisfaction.
- Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
- Basic Claim adjustment for commercial and Blue card home claims
- Met quality, quantity, and timeliness standards to achieve individual and department performance goals.
- Document and record facts related to inquiries and correspondence by updating BCBSAZ files and systems
- Demonstrate and maintain current working knowledge of the required BCBSAZ systems, procedures, forms, and manuals.
- Facilitated contracts for benefits, coverage changes, and eligibility for BCBSAZ programs and provider networks
- Managed team resources by assigning tasks, monitoring progress, and ensuring deadlines were met to maintain operational efficiency.
Member Service Representative
Centene Corporation
Phoenix
10.2021 - 03.2023
- Responded to member and provider inquiries via telephone and written correspondence within established time frames, utilizing reference materials and available resources to ensure accurate information delivery
- Provide assistance to members and/or providers regarding website registration and navigation
- Documented activities for quality and metrics reporting in Customer Relationship Management (CRM) application, contributing to data-driven insights for service improvement
- Processed written customer correspondence with timely follow-up, ensuring member queries were addressed effectively
- Coordinate member transportation and make referrals to other departments as appropriate
- Maintain performance and quality standards based on established call center metrics including turn-around times
Customer Service Expert
CareCentrix
Phoenix
01.2020 - 09.2021
- Work collaboratively with patients, network providers, nurses, referral coordinators office and hospital
- Support team as a SME on the production floor when nesters have questions
- Assist trainer in new hire classes, answering their questions and showing them how to use their tools
- Run reports and help current staffing leads with updating numbers on the board when requested
- Fulfilled physician orders for patients' home health and durable medical equipment needs.
Data Entry Specialist
Becton Dickenson (BD)
Phoenix
06.2019 - 12.2019
- Provided internal customer service support for Bard Peripheral Vascular, Bard Biopsy, Salesforce, and domestic customers, ensuring timely resolution of inquiries.
- Answer incoming customer inquiries via phone and email.
- Resolved problems by clarifying and researching answers and alternative solutions.
- Place orders for customers by phone, email and fax for shipment from BPV for over 4000 product codes.
- Collaborated with cross-functional teams to resolve customer and Salesforce issues, enhancing overall service delivery.
Insurance Verification Specialist
McKesson
Phoenix
11.2018 - 01.2019
- Executed 30 to 40 daily outbound calls to health insurance companies, ensuring accurate verification of member benefits for specialty medications
- Verified billing data accuracy, correcting errors to maintain compliance and enhance processing efficiency
- Updated manuals in response to changes in rates, rules, or regulations, ensuring staff had current information for accurate service delivery
- (Contract)
Tier 1 Technical Support
Amazon
Phoenix
05.2017 - 09.2018
- Troubleshoot Ring smart cameras, doorbells, and cellular devices
- Handled 90 to 95 inbound calls daily, addressing customer inquiries and issues promptly
- Interacted with customers via phone and in person, providing product information, processing orders, canceling accounts, and resolving complaints
Customer Service Representative
Logisticare
Phoenix
11.2016 - 03.2017
- Scheduled medical transportation reservations by phone, managing 80 to 90 calls daily
- Resolved customer service or billing complaints through exchanges, refunds, or bill adjustments
- Reviewed insurance policy terms to confirm coverage for specific losses
Medical Records/Scheduler
Ciox Health
Phoenix
08.2016 - 12.2016
- Scheduled appointments for doctors' offices to facilitate retrieval of medical records requested by health plan for annual audits, managing 20 to 30 outbound calls daily
- Retrieved patient medical records for physicians and technicians, supporting efficient patient care and treatment planning
- Ensured security of medical records and maintained confidentiality by adhering to HIPAA guidelines and regulations
Bakery/Deli Clerk
Vons
Temecula
05.2015 - 11.2015
- Placed dough in pans, molds, or on sheets and baked in production ovens or on grills
- Managed slicing and wrapping machines for various baked goods, maintaining product presentation and freshness
- Inspected products for quality, ensuring only fresh items were available for customers
Barista
Starbucks
Las Vegas
03.2011 - 07.2014
- Crafted and served a variety of hot and cold beverages, enhancing customer satisfaction and experience
- Measured, ground, and packaged coffee beans daily to fulfill customer orders efficiently
- Maintained cleanliness of work areas and utensils to ensure compliance with health standards
Sales Associate
Lady Foot Locker
Temecula
10.2010 - 01.2011
- Assisted customers with product selection and provided tailored recommendations.
- Processed customer transactions accurately using point-of-sale systems.
- Educated customers on promotions and loyalty programs, increasing participation and customer satisfaction.
- Collaborated with team members to create an inviting store atmosphere, enhancing customer experience.
- Managed inventory levels and organized merchandise displays to maximize product visibility and accessibility.
- Provided accurate information about products, prices and services.
- Built and maintained relationships with peers and upper management to drive team success.
Education
High School -
Rancho Vista High School
Temecula, CA06.2010
Skills
- Claims processing
- Healthcare insurance
- HIPAA adherence
- Customer service
- Excel and Word
- Data entry accuracy
- Organizational skills
- Leadership mentoring
Personal Information
Title: Customer Service Professional
Timeline
Senior Customer Advocate Claims Specialist
Blue Cross Blue Shield of Arizona
04.2023 - Current
Member Service Representative
Centene Corporation
10.2021 - 03.2023
Customer Service Expert
CareCentrix
01.2020 - 09.2021
Data Entry Specialist
Becton Dickenson (BD)
06.2019 - 12.2019
Insurance Verification Specialist
McKesson
11.2018 - 01.2019
Tier 1 Technical Support
Amazon
05.2017 - 09.2018
Customer Service Representative
Logisticare
11.2016 - 03.2017
Medical Records/Scheduler
Ciox Health
08.2016 - 12.2016
Bakery/Deli Clerk
Vons
05.2015 - 11.2015
Barista
Starbucks
03.2011 - 07.2014
Sales Associate
Lady Foot Locker
10.2010 - 01.2011
High School -
Rancho Vista High School