Cerene Johnston
Charlotte,NC
Summary
Dedicated Customer Service Professional with over 20 years of experience delivering exceptional support in fast-paced environments. Ensured client satisfaction by effectively addressing questions and technical issues, achieving first call resolution. Committed to upholding company integrity and fostering an environment that encourages employee growth and skill development.
Overview
19
19
years of professional experience
Work History
Hub Relations Coordinator Pharmacy Specialist
Blink Health
Pittsburgh, Pennsylvania
04.2025 - Current
- Communicated effectively with doctors and insurance agencies to resolve prescription cost discrepancies.
- Assisted pharmacists in verifying medication orders and patient profiles.
- Provided excellent customer service by answering patient inquiries promptly.
- Created new customer profiles and updated demographics, allergies, and new medications in pharmacy computer systems.
- Assisted in training new employees on pharmacy procedures.
- Participated in continuing education and training to stay current with pharmacy practices and technology.
- Received payment from customers and processed credit card transactions.
Insurance Claims Specialist
New York Life Insurance Co
Pittsburgh, Pennsylvania
05.2022 - 05.2024
- Reviewed insurance claims for accuracy and completeness.
- Reviewed documentation for accuracy and completeness before processing claims.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Processed requests for additional documentation from customers, ensuring timely follow-up to facilitate claims resolution.
- Communicated with clients to gather essential information, enhancing clarity and speed of claims resolution.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Conducted comprehensive investigations and documented findings to negotiate settlements or deny claims effectively.
- Maintained accurate records of all processed claims in accordance with departmental requirements.
- Documented decisions on each claim based on research findings and applicable benefit plans.
Mail Handler
USPS
Pittsburgh, Pennsylvania
12.2021 - 01.2022
- Operated mail processing equipment and manually sorted mail.
- Sorted incoming mail for accurate distribution within facilities.
- Loaded trays of envelopes into automated sorting machines.
- Assisted coworkers in managing high volumes of mail during peak seasons.
- Collaborated with team members to streamline sorting procedures effectively.
- Adhered strictly to postal regulations regarding package size, weight limits.
Case Manager Coordinator
Highmark
Pittsburgh, Pennsylvania
05.2017 - 06.2021
- Completed patient follow-up services, collected data, monitored clinical progress, and coordinated with primary health care providers for comprehensive patient care.
- Facilitated communication among clients, families, and healthcare providers to ensure seamless support.
- Facilitated communication between clients and healthcare providers to ensure service access.
- Managed client caseloads and prioritized tasks effectively.
- Enrolled expecting mothers in Baby Blueprint program to support preparation for childbirth and postpartum care.
- Handled clerical tasks by making phone calls and replying to emails. by making phone calls, replying to emails and data entry.
Senior Customer Service Representative
Highmark
Pittsburgh, Pennsylvania
10.2007 - 05.2017
- Assisted customers with inquiries and resolved issues effectively.
- Handled escalated customer concerns with professionalism and care.
- Resolved escalated customer complaints in a timely manner.
- Handled difficult calls with strong telephone etiquette, ensuring positive customer experiences.
- Coached team members on effective call handling, improving overall team performance.
- Trained current staff on company policies, procedures, and customer service best practices.
- Acted as an escalation point for complex issues requiring additional resources or expertise.
- Collaborated with management to implement initiatives that enhanced employee engagement and satisfaction.
Education
High School Diploma -
Kolbe Cathedral
Pittsburgh, PA06-2002
Skills
- Claims processing
- Medical Insurance Appeals
- Payment processing
- Data Entry
- Microsoft Excel
- Microsoft Office
- Effective communication
- Verbal and written communication
- Problem solving
- Conflict resolution
- Onboarding coordination
- Employee support
Timeline
Hub Relations Coordinator Pharmacy Specialist
Blink Health
04.2025 - Current
Insurance Claims Specialist
New York Life Insurance Co
05.2022 - 05.2024
Mail Handler
USPS
12.2021 - 01.2022
Case Manager Coordinator
Highmark
05.2017 - 06.2021
Senior Customer Service Representative
Highmark
10.2007 - 05.2017
High School Diploma -
Kolbe Cathedral