Leamon Crowe
Bethlehem,PA
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
9
9
years of professional experience
Work History
Provider Services Representative
United Concordia Dental
09.2022 - 07.2023
- Responded proactively and positively to rapid change.
- Educated customers about billing, payment processing and support policies and procedures.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Met customer call guidelines for service levels, handle time and productivity.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Investigated and resolved customer inquiries and complaints quickly.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Customer Service Representative
Independence Blue Cross
02.2018 - 11.2021
- Resolved benefit contract disputes, appeals, and preexisting conditions
- Served as point of contact for ATLAS, ALICO, AHA, ICHP, and AIG/ARM groups to ensure claims processing issues were resolved
- Verified benefits, payments and claim processing issues; addressed policy inquiries for members and providers.
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Prior Authorization Analyst
Cigna Healthspring
07.2017 - 10.2017
- Evaluated and processed authorizations for home healthcare, medical equipment, and hospital admissions
- Contacted providers to obtain additional information
- Collaborated with medical staff to ensure accuracy of records.
Prior Authorization Analyst
Optum Rx
09.2014 - 04.2017
- Monitored documentation to detect trends and identify provider issues
- Engaged with stakeholders to troubleshoot and resolve claims
- Executed prior authorizations and vacation overrides, as well as data entry and verification.
- Evaluated patient histories, complaints, and current symptoms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- serviced 75-90 calls daily
- processed prescriptions from intake to completion.
Education
A.S - Business Administration
National Education Center
Philadelphia, PA1991
Diploma - undefined
West Catholic High School
Philadelphia, PA1987
Skills
- Information Updates
- Complex Product Knowledge
- Verifying Credential
Timeline
Provider Services Representative
United Concordia Dental
09.2022 - 07.2023
Customer Service Representative
Independence Blue Cross
02.2018 - 11.2021
Prior Authorization Analyst
Cigna Healthspring
07.2017 - 10.2017
Prior Authorization Analyst
Optum Rx
09.2014 - 04.2017
A.S - Business Administration
National Education Center
Diploma - undefined
West Catholic High School
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