Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
References
Timeline
Generic

Mercedes Hegwood

Chesapeake,VA

Summary

Experienced Customer Service Specialist with experience in the insurance industry responding to customer insurance inquiries and assisting with claims. Knowledgeable and dedicated team player with outgoing, positive demeanor and proven skills in establishing rapport with clients and contributing to company success. Proficient computer and multi-tasking skills and able to function in fast-paced inbound call center environments.

Overview

13
13
years of professional experience

Work History

CSR II

Anthem/ Elevance Health
Virginia Beach, VA
09.2021 - Current
  • Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, billing, eligibility, and claims
  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Operates a PC/image station to obtain and extract information, documents information, activities, and changes in the database
  • Uses computerized tracking systems for tracking, information gathering, and troubleshooting.
  • Researches and analyzes data to address operational challenges and customer service issues
  • Provide clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.

Switchboard Operator

Sentara Norfolk General Hospital
Norfolk, VA
05.2021 - 09.2021
  • Operated switchboard and routed incoming calls to appropriate departments.
  • Announced important information and emergency notifications over PA system
  • Responded to customer inquiries with patience and positivity to establish excellent first impression
  • Maintained detailed customer call and inquiry logs for performance monitoring
  • Resolved customer issues and complaints promptly and politely, upholding satisfaction
  • Monitored call queues and worked quickly to answer and resolve inquiries within target timeframes

Lead Switchboard Operator

Bon Secours Maryview Medical Center
Portsmouth, VA
11.2013 - 05.2021
  • Trained and mentored new PBX operations employees
  • Answered calls and engaged customers with friendly, professional demeanor
  • Created and maintained company phone directory with current extensions and staff information
  • Announced important information and emergency notifications over PA system
  • Resolved customer issues and complaints promptly and politely, upholding satisfaction
  • Monitored call queues and worked quickly to answer and resolve inquiries within target timeframes
  • Monitored emergency and code alarms, making emergency announcements or routing emergency calls to appropriate location.
  • Maintained accurate records of calls placed and received
  • Followed up on customer inquiries to confirm issues were adequately addressed
  • Installed software applications to track customer calls and enable improved insight
  • Identified service improvement opportunities through call volume and performance reports
  • Answered provider inquiries via email, telephone, and written correspondence.
  • Assisted administrative team with accepting orders, scheduling appointments or meeting rooms or sending and receiving faxes.
  • Scheduled and confirmed appointments and meetings for management team.
  • Assisted in maintaining office supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing orders for supplies; verifying receipt of supplies.
  • Interviewed individuals to complete documents, case histories or forms.
  • Generated weekly payroll information based on hours worked by employees as indicated in their respective schedules.
  • Collaborated closely with other IT personnel on projects related to telecom infrastructure upgrades.

Cashier/ Salesfloor Rep

Target
Virginia Beach
04.2011 - 11.2013
  • Greeted customers entering store and responded promptly to customer needs
  • Built relationships with customers to encourage repeat business
  • Operated cash register for cash, check, and credit card transactions with excellent accuracy levels
  • Worked flexible schedule and extra shifts to meet business needs
  • Answered questions about store policies and addressed customer concerns
  • Assisted customers with returns, refunds, and resolving transaction issues
  • Worked with floor team and managers to meet a wide range of customer needs
  • Maintained current knowledge of store promotions and highlighted sales to customers
  • Processed refunds and exchanges in accordance with company policy.

Education

Bachelor of Science - Healthcare Administration

Southern New Hampshire University
Online
06-2025

High School Diploma -

Bayside High School
Virginia Beach, VA
06.2010

Skills

  • Strong ability to establish and build relationships
  • Strong ability to allocate resources to ensure timely service
  • Proficient use of MS Word Excel and related programs
  • Superior ability to manage multiple tasks efficiently
  • Proficient written and verbal communications skills
  • Problem Solving
  • Call Metrics
  • Customer Service
  • Data Entry
  • Medical Terminology Knowledge
  • Insurance Claims Review
  • Knowledge of multiple systems (Facets, Compass Solution Central, Macess, ACMP, CIRS Kronos Intellidesk, Genesis cloud,WDE,

Languages

English
Professional

Accomplishments

  • "You make a Difference Award"

References

References available upon request.

Timeline

CSR II

Anthem/ Elevance Health
09.2021 - Current

Switchboard Operator

Sentara Norfolk General Hospital
05.2021 - 09.2021

Lead Switchboard Operator

Bon Secours Maryview Medical Center
11.2013 - 05.2021

Cashier/ Salesfloor Rep

Target
04.2011 - 11.2013

Bachelor of Science - Healthcare Administration

Southern New Hampshire University

High School Diploma -

Bayside High School

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