Effective Senior Customer Service Specialist with 10+ years of experience assisting customers using active listening and customer needs assessment to offer targeted solutions. Consistently friendly and professional when handling diverse customer needs in high-volume call center environments. Smoothly manage workflow and optimize team strengths to meet service quotas.
Work History
Health Information Representative I
Elevance Health
10.2022 - 12.2022
Developed appropriate and accurate written and oral responses to communicate scientific and health information to public.
Followed up with patients about medical and healthcare processes.
Resolved concerns with products or services to help with retention and drive sales.
Answered average of 70 calls addressing customer inquiries, solving problems and providing product information.
Offered internal and external customers first-rate customer service to maximize satisfaction and business success.
Collected customer feedback and made process changes to exceed customer satisfaction goals.
Provided initial contact between distinct Care Management programs and specific identified members.
Handled inbound/outbound enrollment and engagement calls with eligible members to provide information regarding medications.
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Answered customer telephone calls promptly to avoid on-hold wait times.
Health Information Specialist Lead
CIOX HEALTH, Health Information Managment
11.2021 - 09.2022
Sorted, scanned and indexed documents, developed workflows and processed workflow reports to keep clinical records maintained in accordance with guidelines.
Directed and assisted pulling and procurement of medical files according to established procedures.
Maintained relationships with medical providers, suppliers and reporters.
Monitored and tracked inventory, assigned work tasks and adjusted assignments based on priorities.
Trained and backed reception area, on-call and distribution runs to facilitate quality customer care.
Followed up with patients about medical and healthcare processes.
Retrieved medical data for physicians and patients.
Coordinated Care Specialist
EmblemHealth (CGCGROUP)
06.2021 - 09.2021
Facilities and Providers Reach out to obtain prior authorization for testing and OP, IN, procedures, and ER admission.
Input all patient data regarding claims and prior authorizations into Salesforce accurately.
Authorized surgical and medical requests by applicable plan guidelines.
Tracked referral submission before facilitation of prior authorization issuance.
Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Managed over 50 provider calls per day.
Customer Service I
Centene (Fidelis Care)
04.2019 - 03.2021
Cultivated customer loyalty, promoted repeat customers and improved sales
Used company troubleshooting resolution tree to evaluate technical problems while leveraging personal expertise to find appropriate solutions
Assisted customers with setting appointments, shipping and special order requests, and arranging merchandise pick-up at other locations
Consulted with outside parties to resolve discrepancies and create effective solutions
Provided primary customer support to internal and external customers in fast-paced environment
Presented insurance options to customers in order to close sales on new policies
Processed 50 invoices daily and mailed documentation to clients
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
Operations Support Specialist
Cox Automotive Inc.
01.2017 - 02.2019
Researched, Updated all required materials needed for Dealerships and Department of Motor Vehicle
Copied, logged, scanned supporting documentation
Answered average of 100 calls, emails and faxes per day, addressing dealership inquiries, solving problems and providing new memo information
Obtained documents, clearances, certificates and approvals from local, state and federal agencies
Verified data integrity and accuracy
Entered details such as payments, account information and call logs into computer system
Sorted and placed mail into mailboxes with accuracy and efficiency
Weighed letters and packages and calculated costs based on classification, weight, and destination
E-mailed Dealerships, Vendors and D.M.V with shipping updates
Handled high volume paperwork and collaborated with accounting department to resolve invoicing and shipping problems
Shipping and Receiving Manager
Lord & Taylor
10.2015 - 02.2017
Verified that all returns were being completed within 24-hour timeframe from receipt in fulfillment area
Unloaded incoming trucks and properly staged inventory
Prepared envelopes, packages, containers and pallets with correct merchandise counts
Reviewed daily queue report daily to ensure all orders were processed within shipping system
Promoted and maintained safe work environment ensuring compliance with company safety policies
Trained and developed new sales team associates in product knowledge, selling techniques and company procedures
Performed basic mathematical calculations to check weights and dimensions of shipments
Coordinated efficient storage areas to optimize materials movements and minimize labor hours
Negotiated with various freight companies and received annual contracts resulting in cost savings of 40%.
Education
Associate Of Science - Health Information Management
Hudson Valley Community College
Troy, NY
2021
Associate Of Science - Business Administration And Management
Sullivan County Community College
Loch Sheldrake, NY
2007
Skills
Customer Experience
Ability To Manage
Outbound and Inbound Calls
Verbal And Written Communication
Microsoft Office Suite
Technical Documents Comprehension
Professional Manner
Customer Service Support
Schedule Appointments
Human Resources
Excellent Interpersonal Skills
Audit
Timeline
Health Information Representative I
Elevance Health
10.2022 - 12.2022
Health Information Specialist Lead
CIOX HEALTH, Health Information Managment
11.2021 - 09.2022
Coordinated Care Specialist
EmblemHealth (CGCGROUP)
06.2021 - 09.2021
Customer Service I
Centene (Fidelis Care)
04.2019 - 03.2021
Operations Support Specialist
Cox Automotive Inc.
01.2017 - 02.2019
Shipping and Receiving Manager
Lord & Taylor
10.2015 - 02.2017
Associate Of Science - Health Information Management
Hudson Valley Community College
Associate Of Science - Business Administration And Management