Preshenique Grant
Winter Haven,FL
Summary
I am an experienced motivated Customer Service Representative with a track record of providing exceptional support and solving customer inquiries. I have extensive experience in the industry, including more than 3 years working as a customer service representative. I am knowledgeable and proficient in managing high chat/SMS volumes, meeting enrollment, and ensuring customer satisfaction. I pride myself on my ability to deliver accurate information, ordinate sales agreements, and navigate online processes. I am highly solutions-oriented and skilled in identifying customer needs and recommending appropriate solutions all on top of being organized, detail-oriented, and have strong communication skills.
Overview
5
5
years of professional experience
Work History
Customer Service Associate
Cigna
09.2024 - Current
- Delivers straightforward administrative and/or other basic business services in Customer Service.
- Receives requests by mail, telephone, or in person regarding insurance claims/ policies.
- Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
- Mails or routes claim forms and supporting documentation to various units for final processing.
- Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions.
- Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
- Good knowledge and understanding of Customer Service and business/operating processes and procedures.
Claims Specialist
Allstate Insurance
Lakeland, FL
05.2024 - 09.2024
- Resolved claims disputes, requests for clarification, and appeals in an efficient and timely manner
- Communicates effectively with internal and external customers
- Identifies the customer's need and responds appropriately and efficiently with a sense of urgency
- Locates, confirms and documents appropriate information, which may involve multiple systems
- Remains current on constant process updates and technology used within the company
- May utilize multiple communication channels including but not limited to telephone, fax, email, or online chat to assist the client
- Handle all First Notice of Loss (FNOL) calls for both Auto and Property customers
- Handle inquiry calls for both Auto and Property customers, making decisions on claims
- Provide exceptional Customer Experience based on claims service and quality standards
- Responding to customers with empathy, care and concern
- Secure and accurately document all details concerning a loss
- Explain claim process and next steps as necessary
- Set up Method of Inspections and/or Emergency Services where required
Member Service Representative
WellDyne
Lakeland, FL
03.2022 - 04.2024
- Acts as a liaison between Specialty Care Pharmacy, patients and the provider's office
- Responsible for ensuring all necessary information, including insurance verification, is available to process prescription orders
- Assist in collecting clinical outcomes data from patients and assist in tracking the data within the software system
- Responsible for explaining company programs and services to patients and provider's office staff
- Communicates with patient for prescription refills
- Refers any medication or illness related question or concerns to a board licensed healthcare professional
- Responsible for processing of prescription refills through pharmacy dispensing software
- Maintains documentation of calls to and from patients and providers
- Contact patients to schedule deliveries, confirm address, inform of any co-payment information, and notify of payment responsibilities
- Assists with prior authorizations
- Refers under/uninsured patients to appropriate patient assistance programs and assists with applications
- Keeps current with new treatment trends
- Communicates patient status to provider's office/clinics
- Maintains patient confidentiality
- Performs other duties and responsibilities as assigned
- Executed company policies, procedures, and safety standards to ensure the proper cleanliness and safety of the office and equipment
- Worked with departments across the company, including marketing and project management, in developing new ideas, initiatives, products, and services
Customer Service Representative
Ttech Health Solutions
Lakeland, FL
12.2020 - 02.2022
- Responded to telephone inquiries and complaints following standard operating procedures.
- Maintained knowledge of company products to provide helpful suggestions and recommendations to customers.
- Delivered personalized customer service relating to questions and promptly resolved basic problems on customer accounts.
- Handled customer complaints and inquiries in a courteous and efficient manner.
- Met daily customer service quotas with a focus on quality.
- Resolve customer issues with patience and understanding
- Handled customer inquiries, answered questions, and resolved problems in a timely manner
- Kept accurate records of all interactions, including customer names, addresses, phone numbers, credit card information, and product sales
Education
High School - undefined
Kathleen Senior High School
Lakeland, FL05.2021
Skills
- Claims Processing, Digital Literacy, Quality Management, Time Management, Inclusive Leadership, Results-Oriented, Relationship Building, Quality Assurance Optimizing, Remote, Health Administration, Call Center Operations, Documentation, Reporting, Customer service, Communication skills, Computer skills, Microsoft word, Data Entry, Insurance Verification
Timeline
Customer Service Associate
Cigna
09.2024 - Current
Claims Specialist
Allstate Insurance
05.2024 - 09.2024
Member Service Representative
WellDyne
03.2022 - 04.2024
Customer Service Representative
Ttech Health Solutions
12.2020 - 02.2022
High School - undefined
Kathleen Senior High School