Summary
Overview
Work History
Education
Skills
Timeline
Generic

Melvin White

Saint Charles,MO

Summary

Dedicated professional with 15+ years of experience in excelling within multiple customer-focused roles by leveraging exceptional communication, problem-solving, multitasking, and negotiation skills. Capable of handling both simple and more complex customer-facing responsibilities and communication functions to optimize customer service and ensure maximum levels of satisfaction and repeat business. Ability to track and evaluate CSR performance to drive quality service, professionalism, and courtesy while identifying actions to improve call quality and customer retention.

Overview

11
11
years of professional experience

Work History

Center Supervisor

Verizon Wireless
  • | Call Center Representative

National Operations Coordinator / Credentialing Coordinator

Express Scripts Incorporated
  • | Call

Patient Access Representative

SSM Health Saint Louis University Hospital
10.2024 - Current
  • Managed patient registration processes, ensuring accurate data entry and compliance with healthcare regulations.
  • Assisted patients with insurance verification, streamlining the approval process and enhancing customer satisfaction.
  • Coordinated appointment scheduling, optimizing provider availability and improving patient flow throughout the facility.
  • Educated patients on financial responsibilities, fostering transparency and reducing billing inquiries.
  • Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
  • Stayed calm under pressure to and successfully dealt with difficult situations.
  • Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.

Customer Service Specialist

Lumeris Inc.
07.2019 - 10.2024
  • Deliver extensive customer support by promptly responding to customer calls, resulting in positive experiences and feedback
  • Address customer inquiries related to health plans and communities, including benefit and eligibility information, billing and payment issues, EOB, and others to assure seamless communication flow
  • Tactfully handle escalated situations by leveraging problem-solving skills and taking swift actions to prevent grievances
  • Manage X no. of outbound calls while engaging with members, providers, pharmacies, hospitals, and other stakeholders to efficiently resolve issues and drive customer satisfaction
  • Conduct thorough investigations to provide comprehensive responses to both general and complex inquiries along with recording essential information in the system for future use and reference
  • Collaborate with other departments, such as Enrollment and Medical Management to maximize coordination and realize operational effectiveness
  • Avoid violations and inconsistencies by maintaining strict compliance with regulatory requirements and CMS standards throughout all interactions and processes

Customer Care Advocate

Magellan Health Care
12.2018 - 03.2019
  • Handled over X no. of field provider calls while addressing inquiries related to patient benefits, coverage, and claims, and effectively conveying members’ benefits to providers to gain trust and confidence
  • Facilitated seamless communication and information flow by accurately forwarding necessary paperwork to the Credentialing team for timely approvals
  • Utilized exceptional attention to detail and organizational skills during creation and reviews of authorizations for members to undergo mental health procedures, resulting in enhanced accuracy
  • Analyzed claims-related concerns along with explaining issues and taking prompt actions to initiate reprocessing as required to ensure swift payments

Caretaker

Career Break Example
12.2017 - 11.2018
  • Supported parent through serious illness, providing at-home care to ensure their well-being

Platinum Provider Relations Representative

United Health Care
02.2015 - 11.2017
  • Answered X no. of inbound customer calls to address inquiries, process claims, resolve issues, and provide customer support
  • Updated and maintained required information and customers’ records for swift access and retrieval
  • Reviewed information given by the customer to identify problems and discuss solutions/next steps based on the nature of the inquiry, resulting in swift resolutions
  • Adhered to established escalation procedures while mitigating complaints/escalations on the first contact to ensure consistency and uniformity

Education

College - Criminal Justice

Southeast Missouri State University

Skills

  • Conflict resolution skills
  • Customer service expertise
  • MS Office Suite
  • Client Satisfaction & Retention
  • Strong verbal communication
  • Presentation & Interpersonal Skills
  • Microsoft Excel
  • Effective time management
  • Sales Management
  • Organizational Abilities
  • Microsoft Office
  • Effective team engagement

Timeline

Patient Access Representative

SSM Health Saint Louis University Hospital
10.2024 - Current

Customer Service Specialist

Lumeris Inc.
07.2019 - 10.2024

Customer Care Advocate

Magellan Health Care
12.2018 - 03.2019

Caretaker

Career Break Example
12.2017 - 11.2018

Platinum Provider Relations Representative

United Health Care
02.2015 - 11.2017

Center Supervisor

Verizon Wireless

National Operations Coordinator / Credentialing Coordinator

Express Scripts Incorporated

College - Criminal Justice

Southeast Missouri State University

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