Experienced customer service representative with inbound, outbound, data entry, call auditing. Seeking a role that will use my experience and further my skills.
Overview
8
8
years of professional experience
Work History
Maine Marketplace Insurance Enrollment Specialist
TEKsystems
Charleston, South Carolina
10.2025 - Current
Handled customer assistance calls to resolve inquiries, enhancing customer satisfaction and service experience.
Streamlined completion of paperwork and documentation for applicants, ensuring accuracy and compliance.
Conducted informational sessions to clarify program offerings and benefits, adhering to HIPAA regulations.
Utilized systems including Genesis, Workday, Fieldglass, and Microsoft Teams for remote operations.
Customer Service Representative
TEKsystems
Charleston, South Carolina
09.2023 - 07.2025
SC Medicaid, Communicated with applicants through outbound calls to ensure clarity in processes.
Maintained accurate records of customer interactions and transactions, ensuring data integrity.
Routed cases to appropriate departments for efficient processing.
Developed workbooks to evaluate financial statuses, facilitating Medicaid eligibility assessments.
Collaborated with teams using Microsoft Excel, OnBase, Jabber, WebEx, DOS, and Curam.
Analyzed evidence to inform decisions that enhanced operational effectiveness.
Contracted services for SCDHHS, SC Medicaid, and Medicare projects.
Customer Service Representative
Live OPS
03.2023 - 09.2023
Assisted callers with insurance inquiries, adhering to HIPAA regulations for privacy and security.
Managed customer inquiries through multiple communication channels.
Resolved issues by analyzing customer needs and providing effective solutions.
Documented customer interactions using company-specific software tools.
Supported Amerihealth Medicaid online inquiries, ensuring accurate information delivery.
Customer Service Representative
Everise
08.2022 - 03.2023
Assisted members with insurance coverage and prescription formulary inquiries, ensuring accurate and timely resolution.
Assisted members with insurance coverage, prescription formulary inquiries, and web support.
Researched and implemented solutions to effectively address member questions and concerns.
Delivered exceptional customer service for WellCare Medicare and Medicaid services, enhancing member satisfaction.
Customer Service Representative
Live OPS
06.2019 - 10.2022
Facilitated patient assistance by providing guidance on Cologuard processes during inbound and outbound calls.
Executed reminder and incentive calls, enhancing test completion rates.
Assessed patient eligibility, ensuring appropriate follow-up for Cologuard test re-completion.
Ensured strict adherence to HIPAA regulations in all documentation practices.
Coordinated with Exact Sciences Laboratories to optimize contractor operations for Cologuard.
Call Auditor
Live Ops
02.2020 - 02.2022
Evaluated inbound and outbound calls for compliance with HIPAA regulations and client business rules.
Monitored calls for quality assurance, ensuring compliance with client expectations and contributing to overall service quality.
Quality Control call auditing, time management
Documented call data in Google Sheets and call; participated in meetings and group discussions to enhance team collaboration.
Customer Service Representative
Live OPS
05.2018 - 06.2019
Honk roadside assistance services with Live Ops on November 8, 2018.
Utilized computer systems to locate addresses and estimate tow truck arrival times, enhancing response accuracy.
Provided directions to tow truck drivers, enabling efficient navigation and improving customer support.
Some College (No Degree) - Diagnostic Medical Sonography-Certificate
Trident Technical College
Charleston, SC
08-1996
NEI Truck Driving Training-Certificate - Truck Driving
NEI Truck Driver Training Course
Charleston, SC
03-1991
Skills
Customer service
Issue resolution
HIPAA compliance
Data privacy
Call auditing
Client platform knowledge
Strong computer skills
Microsoft office
Organizing
Scheduling
Multitasking
Adaptability
Problem resolution
Effective communication
Professionalism
Leadership Experience
Ability to lead a team in study groups, and individuals to teach, help others to research to find their answers. Strong organizational skills always help with performance, and implement quality results in a company’s customer loyalty and growth.
Communication Skills
Strong verbal communication skills, and written skills with the ability to be unbiased, provide constructive feedback and suggestions along with accepting feedback to acknowledge areas I need to improve on and accelerate in.
Timeline
Maine Marketplace Insurance Enrollment Specialist
TEKsystems
10.2025 - Current
Customer Service Representative
TEKsystems
09.2023 - 07.2025
Customer Service Representative
Live OPS
03.2023 - 09.2023
Customer Service Representative
Everise
08.2022 - 03.2023
Call Auditor
Live Ops
02.2020 - 02.2022
Customer Service Representative
Live OPS
06.2019 - 10.2022
Customer Service Representative
Live OPS
05.2018 - 06.2019
Associate in Science Degree - Science Education
Trident Technical College
Some College (No Degree) - Diagnostic Medical Sonography-Certificate
Trident Technical College
NEI Truck Driving Training-Certificate - Truck Driving