MELICIA GOLDSON
Margate,FL
Summary
CUSTOMER SERVICE REP / 15 YEARS' EXPERIENCE IN CALL CENTER SETTINGS Polished, professional customer service rep offering: 15
years of experience providing customer support in busy call center environments for public utility and insurance industry employers. An unwavering commitment to customer service, with the ability to build productive relationships, resolve complex issues and win customer loyalty. Strategic-relationship/partnership-building skills listen attentively, solve problems creatively, and use tact and diplomacy to find common ground and achieve win-win outcomes.
Overview
17
17
years of professional experience
Work History
Patient Navigator Representative
Holy Cross Hospital, Fort Lauderdale
Fort Lauderdale , FL
07.2020 - Current
- Assisted patients in scheduling doctor and healthcare appointments.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Participated in regular team meetings, huddles, staff meetings and quality improvement projects to improve patient care.
- Identified barriers when treatment goals not met, treatment plan not followed or important appointments missed and collaborated in redeveloping patient treatment goals.
- Educated patients on insurance and healthcare plans.
Senior Customer Service Rep/Enrollment Specialist
Optum INC
Fort Lauderdale, FL
10.2012 - Current
- Work with over 20 plus hospital, clinics, facilities and our clinical team to manage SLA requirement for services from members and / or providers
- Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
- Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage
- Review requests for adverse determination, approval notification and processing notification requirements
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review, to help meet our clients’ needs that is required by contract
- Handle resolution/inquiries from members and/or providers that may include: Benefit and Eligibility information Billing and Payment issues Customer material requests Physician assignments Authorization for treatment Explanation of Benefits (EOB)
- Recognized as’#1 customer service rep “(out of 20 reps in my division) from 2013-2016 from accuracy, customer service, duration of calls, availability and meeting SLA which to contributed to an 8%sales increase by improving lead generation and sales-tracking techniques
- Became the lead "go-to" person for new reps and particularly challenging calls as one of the company’s primary mentors/trainers of both new and established employees
- Helped company attain the highest customer service ratings (as determined by external auditors).
Technical Support Agent
Tele performance
North Lauderdale, FL
10.2010 - 09.2012
- Interface daily with internal partners in accounting, field services, new business, operations and consumer affairs divisions
- Handle customer inquiries, complaints, billing questions and payment extension/service requests
- Calm angry callers, repair trust, locate resources for problem resolution and design best-option solutions
- Managed a high-volume workload within a deadline-driven environment
- Resolved an average of 550 inquiries in any given week and consistently meet performance benchmarks in all areas.
Customer Service Agent
Interactive Response Technology
07.2009 - 09.2010
- Lauderdale Lakes, FLAnswering inbound calls for AT&T customer regarding billing inquiries, processing payments and handling technical issues
- Provide effective and timely resolution for a range of customer inquiries.
Customer Service Agent
Convergys
Tamarac, FL
02.2007 - 05.2009
- Completed voluntary customer service training to learn ways to enhance customer satisfaction and improve productivity
- Focused on the credit and fraud risk inherent to each of the payment methods accepted and helped protect the organization from fraudulent activities
- Evaluate customer’s spending patterns and investigate high risk or suspicious activity and identify areas of concerns to minimize potential risk
- Meeting fraud loss reduction targets through appropriate rule analysis, implementation and suggestion for process improvement.
- Entered customer interaction details in sales system to track requests, document problems and record solutions offered.
- Addressed escalated customer service issues sent from sales and service teams to save customer relationships.
- Communicated with clients regarding account services, statements, and balances.
Education
Diploma - undefined
Med Vance Institute
11.2010
High School Diploma - undefined
St. Mary
07.2000
Skills
- Efficiency in
- Windows 7
- Efficiency in Microsoft office products
- Data Entry/Records Management
- Multiline Phone Use
Accomplishments
- Monetary Transactions - Handled cash, check, credit and automatic debit card transactions with 100% accuracy.
- Cashier - Achieved highest Number of new credit accounts opened within one-month period.
- Compiled inventory lists and worked with vendors for product pricing and special orders. Handled high volume sales with cash, credit and gift card transactions, balancing cash draw at end of shift with 100% accuracy rate.
Timeline
Patient Navigator Representative
Holy Cross Hospital, Fort Lauderdale
07.2020 - Current
Senior Customer Service Rep/Enrollment Specialist
Optum INC
10.2012 - Current
Technical Support Agent
Tele performance
10.2010 - 09.2012
Customer Service Agent
Interactive Response Technology
07.2009 - 09.2010
Customer Service Agent
Convergys
02.2007 - 05.2009
Diploma - undefined
Med Vance Institute
High School Diploma - undefined
St. Mary
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