Summary
Overview
Work History
Education
Skills
Professionalextracurricularactivities
Timeline
Generic

Kristy Whistler

Windber,PA

Summary

I will be an advocate and uphold the highest standard of performance for your company. Keen observation, communication, and intervention skills. Adapt easily to change of environment and work schedule.

Diligent Claims Representative with solid background in managing customer claims and resolving issues efficiently. Successfully handled numerous customer inquiries, ensuring satisfaction and compliance with company policies. Demonstrated strong communication and problem-solving skills to deliver exceptional service and maintain positive customer relationships.

Experienced with handling customer claims and resolving inquiries promptly. Utilizes strong communication and problem-solving skills to address customer needs effectively. Track record of maintaining positive relationships and ensuring client satisfaction through efficient service delivery.

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.

Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Overview

32
32
years of professional experience

Work History

Claims Customer Service Representative

MyAdvisors
10.2023 - Current
  • Streamlined claims processing for quicker resolutions, utilizing thorough investigation techniques and attention to detail.
  • Promoted a positive work environment by actively participating in team meetings, sharing best practices, and offering constructive feedback to peers.
  • Reduced errors in claim submissions by providing clear guidance to policyholders on required documentation and information needed for processing.
  • Enhanced customer satisfaction by efficiently resolving claims and addressing policyholder concerns.
  • Supported departmental goals by consistently meeting or exceeding performance metrics in quality, accuracy, and timeliness.
  • Fielded customer complaints, escalating complex issues to management for resolution.
  • Documented customer interactions and transactions for accurate, up-to-date records.
  • Assisted customers with completing insurance documents to avoid missed information.
  • Checked documentation for accuracy and validity on updated systems.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Ensured accurate documentation and record-keeping, adhering to company policies and industry regulations.
  • Managed high call volume while maintaining professionalism, empathy, and attention to detail in each interaction.
  • Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.

Server

Applebee's
07.2020 - 10.2023
  • Increased sales with upselling techniques and thorough knowledge of menu items, specials, and promotions.
  • Performed opening and closing duties, ensuring the dining area was prepared for seamless service transitions.
  • Collaborated with team members during busy shifts for efficient workflow and excellent guest experiences.
  • Served food and beverages promptly with focused attention to customer needs.
  • Resolved customer complaints promptly and professionally to maintain positive reputation.
  • Explained menu items and suggested appropriate options for food allergy concerns.
  • Worked with POS system to place orders, manage bills, and handle complimentary items.
  • Cultivated warm relationships with regular customers.
  • Followed health and safety protocols crucial for maintaining safe and sanitary environments for customers and staff.
  • Maintained clean and organized dining areas to uphold restaurant hygiene standards.
  • Provided attentive service during high-volume periods without sacrificing attention to detail or guest rapport.
  • Demonstrated strong multitasking skills by managing multiple tables simultaneously without compromising service quality.

Service Technician

Advanced Office Systems
04.2019 - 07.2020
  • Repaired copiers, fax machines, scanners, and printers.
  • Scheduled routes and appointments.
  • Provided evaluations for repairs to customers and estimates.
  • Adhered to safety protocols and policies to reduce workplace hazards.
  • Evaluated systems according to predetermined checklist and noted issues.
  • Installed new equipment and explained operation and routine maintenance protocols to customers.
  • Explained diagnostic findings to customers and outlined repair or service options.
  • Diagnosed and troubleshot problems, repairing, and restoring machines to peak performance.
  • Inspected equipment to diagnose operational issues.
  • Reduced equipment downtime by performing regular maintenance checks and resolving potential problems.
  • Contributed to increased first-time fix rates by thoroughly diagnosing issues before initiating repairs or replacements.
  • Responded to problems reported by customers by troubleshooting and resolving hardware and software issues.
  • Responded to customer inquiries quickly and professionally to increase satisfaction.

Nursing

Laurelview Nursing
08.2009 - 01.2014
  • Ensure that policies and procedures for confidentiality and HIPPA regulations are met.
  • Supervision of staff members.
  • Ensure open lines of communication.
  • Accurate charting procedures.
  • Report changes in the clients condition and other matters of concern requiring prompt attention.
  • Improved patient outcomes by delivering timely, high-quality nursing interventions during emergencies.
  • Assessed nursing workloads and pitched in to help in high-volume areas.
  • Assisted nursing staff in maintaining a safe and clean environment for patients.
  • Enhanced patient satisfaction through effective communication and compassionate nursing care.
  • Implemented evidence-based teaching strategies to effectively convey complex nursing concepts.
  • Improved patient satisfaction scores by providing compassionate and attentive nursing care.
  • Improved patient care quality by implementing effective nursing protocols and procedures.
  • Mentored new nursing staff, sharing expert knowledge in the field of operating room nursing and helping them grow professionally.
  • Streamlined nursing processes for increased efficiency and better patient care.
  • Participated in continuing education opportunities related to nursing best practices.
  • Increased patient satisfaction scores by providing compassionate, personalized nursing care during treatments.
  • Designed and implemented standards of care for nursing and patient care.
  • Assisted nursing team with answering phones and updating medical charts.
  • Managed day-to-day operations and workflows for nursing department.
  • Led daily nursing rounds to assess patient progress and address any concerns.
  • Mentored new nursing staff, supporting their professional growth and development.
  • Trained new Certified Nursing Assistants, ensuring high-quality care standards were maintained.
  • Built and deepened partnerships with healthcare administrators, medical directors and nursing supervisors.

Secretarial/Office Manager

Windber Medical Center
04.1993 - 09.2006
  • Scheduling, referrals, registration, billing, A/P and A/R
  • Answering multi-line phone
  • Disseminating mail, supply management, inventory
  • Transcription, filing, copying, faxing and management of staff members
  • ICD/CPT coding and insurance verification
  • Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
  • Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
  • Supported department heads in accomplishing their goals through diligent administrative assistance such as report generation and data entry.
  • Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
  • Defined clear targets and objectives and communicated to other team members.
  • Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
  • Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.
  • Facilitated smooth communication between departments, addressing concerns promptly to maintain harmonious work relationships.
  • Contributed to workplace safety by ensuring compliance with established emergency protocols and conducting regular equipment inspections.
  • Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
  • Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
  • Streamlined office operations by implementing efficient filing systems and organizational strategies.
  • Oversaw facility maintenance requests, coordinating with building management to address repairs or improvements efficiently.
  • Controlled resources and assets for department activities to comply with industry standards and government regulations.
  • Maintained professional demeanor by staying calm when addressing unhappy or angry customers.

Education

Diploma - Practical Nursing

Greater Johnstown CTC
Johnstown, PA
08.2009

Diploma - Physical Therapy Aide

Harcourt Learning Direct
Cambridge, MA
03.2001

Diploma - Nursing assistance

Greater Johnstown CTC
Johnstown, PA
06.1995

Associates Degree - Medical Secretarial

Cambria Rowe Business College
Johnstown, PA
11.1993

Diploma - Clothing &Fashion

Greater Johnstown CTC
Johnstown, PA
06.1991

Skills

  • Compliance Awareness
  • Call Management
  • Customer Education
  • Data entry proficiency
  • Policy Interpretation
  • Billing resolution
  • Claims support
  • Claim processing
  • Call triage
  • Insurance knowledge
  • Complaint Handling
  • Client Education
  • Insurance terminology
  • Teamwork and Collaboration
  • Customer Service
  • Problem-Solving
  • Attention to Detail
  • Claims Investigation
  • Reliability
  • Excellent Communication
  • Critical Thinking
  • Decision-Making
  • Teamwork skills
  • Microsoft Office
  • Computer Proficiency
  • Documentation skills
  • Medical Terminology
  • Prior authorization processing
  • Document Review
  • Insurance Claim Forms Review
  • Coverage Determination
  • Medicaid knowledge
  • Understanding of medical terms
  • Denied claims identification
  • Information Verification

Professionalextracurricularactivities

  • Planned and implemented educational seminars and patient assistance programs, health events throughout the regions of Bedford, Cambria, and Somerset counties
  • Assisted with preparation of state inspections and surveys
  • Secretary of a non-profit organization; responsible for marketing and obtaining sponsorships

Timeline

Claims Customer Service Representative

MyAdvisors
10.2023 - Current

Server

Applebee's
07.2020 - 10.2023

Service Technician

Advanced Office Systems
04.2019 - 07.2020

Nursing

Laurelview Nursing
08.2009 - 01.2014

Secretarial/Office Manager

Windber Medical Center
04.1993 - 09.2006

Diploma - Practical Nursing

Greater Johnstown CTC

Diploma - Physical Therapy Aide

Harcourt Learning Direct

Diploma - Nursing assistance

Greater Johnstown CTC

Associates Degree - Medical Secretarial

Cambria Rowe Business College

Diploma - Clothing &Fashion

Greater Johnstown CTC

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Kristy Whistler