SERENA T. HORTON
Detroit,MI
Summary
Hardworking Professional with 20 years of experience working with Healthcare. Trained in problem-solving, project and time management with extensive knowledge of customer service and proven multitasking abilities working in fast-paced environment. Committed to maintaining professional relationships with clients to increase profitability and drive business results.
Overview
22
22
years of professional experience
Work History
Customer Service Advocate
Blue Cross Blue Shield Of Michigan & Blue Care Network
Detroit, MI
06.2001 - Current
- Handle high volume of telephone, and written correspondence in call center.
- Assist and support coordinating special projects, meetings, and recommend policy decisions.
- Adhere to division and corporate scope to enhance overall efficiency of operational procedures, methods, controls, and performance.
- Advance awareness of medical terminology, underwriting, diagnostic, and data processing.
- Maintain communication between clients, providers, agents, CMS, Health Insurance Marketplace
- Analyze complex billing, benefits, claims, membership issues.
- Interpret & distribute benefit material, conduct internal/external research via phone, email, fax, and mail upon request.
- Assist Agents and Managing Agents with commission and membership status.
- Educate clients on all levels of business including medical, dental, vision, hearing, and prescription drugs.
Customer Service Analyst
Electronic Data System, EDS
Farmington Hills, MI
10.1998 - 11.2000
- Process and adjust finance payments and rewards.
- Prepare daily reports, organized general accounting functions.
- Monitor dealer sales activities to ensure satisfactory service and quality goods.
- Instruct new hires, provide new material using various teaching methods, conduct weekly sales meeting.
- Collected customer feedback and made process changes to exceed customer satisfaction goals 100%.
Education
Business/ Health Care Administration
Wayne County Community College
Detroit, MISkills
Customer Service
Problem Solving
Data processingPeople skills
Multitask
InsuranceComputer Skills
QualityCurrent Procedure Terminology(CPT) ICD-10 Diagnostic
Resourceful and detailed oriented
Time ManagementCommunication Skills
Timeline
Customer Service Advocate
Blue Cross Blue Shield Of Michigan & Blue Care Network
06.2001 - Current
Customer Service Analyst
Electronic Data System, EDS
10.1998 - 11.2000
Business/ Health Care Administration
Wayne County Community College