Nicole Seville
Marshville,NC
Summary
Proficient in managing schedules, administrative functions and employee training. Disciplined and organized leader with a strong call center background focused on customer relations and team leadership. As well as Dedicated EMT certified of 12 years of excellent performance in medical roles and HIPAA compliance. Offers unwavering work ethic and dedication to patient care. Industrious and focused on continuous professional development
Overview
12
12
years of professional experience
1
1
Certification
Work History
Inbound Contact Representative 2
CarePlus/Humana
01.2022 - Current
- Handling 40-50 inbound calls daily from members in a fast-paced inbound call center environment, and at times, back-to-back phone calls
- Documenting accurate details of inquiries, comments or complaints, transactions or interactions and records all actions taken in accordance to the request or questions being asked
- Decisions are typically focused on detailed processes and area/department policies and methods for completing assignments
- Working within defined parameters to identify work expectations and quality standards, under minimal direction
- Explaining insurance coverage and supplemental benefits
- Reviewing and submission of insuranceAuthorizations/Organization Determination for members in need of specialist and procedures
- Member portal/website troubleshooting
- Scheduling/Cancelling/Activation of trips for member medical visits
- Reviewing claims/submitting claims adjustment request
- Assist with Provider services department inbound calls for Claim status and part D medication coverage.
- Subject matter Expert
- Advance Chat Expert- support agents who are in need of a additional assistance while on complex calls
Inbound Contact Representative 1
CarePlus/Humana
08.2021 - 01.2022
- Handling 40-50 inbound calls daily from members in a fast-paced inbound call center environment, and at times, back-to-back phone calls
- Transportation scheduling.
Office Supervisor
Edwards Plumbing
12.2014 - 08.2021
- Monitored supplier operations to verify quality, delivery schedule and conformance to contract specifications
- Evaluated and processed shift reports to assess metrics and make proactive adjustments to future plans
- Reviewed routes, daily traffic and weather conditions to adjust plans, meeting daily requirements and service needs
- Answered customer requests with information about product availability, shipping information and status updates
- Accurately and efficiently responded to over 20 daily requests
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints
- Consulted with customers to determine best methods to resolve service and billing issues
- Analyzed reports on improvements to improving efficiency
- Set and managed performance benchmarks for call center employees.
Patient Care Assistant
Comfort Keepers
08.2014 - 12.2014
- Promoted patient comfort by quickly responding to calls and handling diverse needs
- Documented information in patient charts and communicated status updates to interdisciplinary care team
- Implemented creative activities to emotionally support patients throughout medical treatment
- Documented patient intake and dietary requirements and aided with feeding and monitoring
- Interviewed patients to obtain medical information, weight and height measurements and vital signs to aid physicians with patient care planning
- Promoted patient satisfaction by assisting with daily living needs such as bathing, dressing, toileting and exercising
- Conducted games and other activities to engage clients and provide mental stimulation and entertainment
- Responded to patient alarms and needs-assessment requests to identify course of treatment.
EMERGENCY MEDICAL TECHNICIAN-BASIC
ATLANTIC COAST MED TRANSPORT
05.2014 - 08.2014
- Evaluated patients' medical status and monitored vital signs during transit
- Conducted equipment inspections and vehicle checks in adherence with required maintenance schedules
- Collaborated with team members and other first responders, ensuring consistent communication to maintain order and efficient care delivery
- Monitored and replenished ambulance supplies, maintaining well-stocked inventory and properly functioning equipment.
Emergency Medical Technician-Basic
Superior Ambulance
08.2012 - 02.2014
- Assessed emergency situations and prioritized medical care for patients
- Rendered direct patient care, including stabilizing patients and determining course of action based on triage
- Developed strong rapport with other medical professionals to foster quality and efficient patient care
- Evaluated patients' medical status and monitored vital signs during transit
- Remained level-headed and proactive during emergency situations
- Trained newly hired EMTs by offering insight into job duties and assessing shift performance.
Skills
- Empathy and patience
- Assertiveness
- Customer Service
- Problem-solving skills
- Call Center Customer Service
- Resolving issues
- Inbound phone calls
Certification
EMT-B, Methodist Hospitals, 05/2010
Timeline
Inbound Contact Representative 2
CarePlus/Humana
01.2022 - Current
Inbound Contact Representative 1
CarePlus/Humana
08.2021 - 01.2022
Office Supervisor
Edwards Plumbing
12.2014 - 08.2021
Patient Care Assistant
Comfort Keepers
08.2014 - 12.2014
EMERGENCY MEDICAL TECHNICIAN-BASIC
ATLANTIC COAST MED TRANSPORT
05.2014 - 08.2014
Emergency Medical Technician-Basic
Superior Ambulance
08.2012 - 02.2014
EMT-B, Methodist Hospitals, 05/2010