Pamela Humphrey
Jacksonville,NC
Summary
Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Overview
36
36
years of professional experience
4038
4038
years of post-secondary education
Work History
Customer Service Representative
Concentrix
12.2023 - Current
- Provide billing information and resolve issues for members regarding premiums.
- Provide technical support, registration assistance, and navigation with the member portal.
- Research medical claims and advise on the status of the claims, amount paid on claims, and date of completion.
- Contact providers regarding claims and corrected member/subscriber information.
- Document in member’s accounts of interaction.
- Participate in weekly meetings, discussing updates.
- Assisted retail pharmacies with any issues filling prescriptions.
- Educated members of their plan’s coverage, medical, and prescription.
- Contract with North Carolina insurance providing Medicare Supplements and Medicare Advantage plans.
Appointment Scheduler Representative
MPF Federal
01.2023 - 04.2023
- Schedule medical appointments on behalf of the Dept of Veteran Affairs.
- Contact providers/facilities to confirm appointments.
- Obtain preferences from Veterans.
- Obtain availability days and times from veterans to assist with scheduling appointments.
- Developed strong working relationships with management and executive team through effective scheduling and communication skills.
- Increased customer service success rates by quickly resolving issues.
- Proactively identified scheduling issues and developed quick solutions to promote efficiency and profitability.
- Contracted with Optum Community Care Scheduling Center.
Member Services
Alorica, Inc
11.2020 - 07.2022
- Filled prescription orders.
- Assisted retail pharmacies with any issues filling prescriptions.
- Resolved billing issues.
- Updated/Confirmed shipping address.
- Educated members of their pharmaceutical benefits.
- Document pertinent information to associated account regarding conversation with caller.
- Obtained knowledge and experience with commercial and governmental insurance, explaining pharmacy benefits for both types.
- Promptly responded to inquiries and requests from prospective customers offering excellent support and tailored recommendations to address needs.
- Met customer call guidelines for service levels, handle time, and productivity.
- Enhanced productivity levels by anticipating needs and delivering outstanding support.
- Prompt delivery service to prioritize customer need.
- Contracted with prominent pharmacy benefits management and mail home pharmacy.
Lenoir Memorial Hospital
Kinston, North Carolina
10.1990 - 09.2003
- Analyzed medical records after discharge.
- Notated physicians and other personnel who need to provide signatures.
- Notated required dictated reports to declare record as completed.
- Filed loose material into patients’ records.
- Contracted provider offices to obtain information.
- Release of information.
- Faxed medial information to provide offices to assist with patients’ appointments.
- Assisted providers with locating records for completion.
- Health information Services.
Education
Bachelor of Social Work -
University of North Carolina-Wilmington
Wilmington, NCAssociates of Arts -
Coastal Carolina Community College
Jacksonville, NCSkills
- Microsoft 365
- HIPAA
- Social Work
- Medical Records
- Medical Office Experience
- Medical Terminology
- Customer Service
- Pharmacy Benefits verification
- Medicare Supplement
- Medicare Advantage
- Data entry
- Teams
- Citrix
- Workspace
- Transcription
Timeline
Customer Service Representative
Concentrix
12.2023 - Current
Appointment Scheduler Representative
MPF Federal
01.2023 - 04.2023
Member Services
Alorica, Inc
11.2020 - 07.2022
Lenoir Memorial Hospital
10.1990 - 09.2003
Bachelor of Social Work -
University of North Carolina-Wilmington
Associates of Arts -
Coastal Carolina Community College