Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Shirl Byrd

Irving,TX

Summary

  • 10+ years of customer service experience (health care, finance, and retail)
  • Strong front office admin experience
  • Insurance Verification Experience (Medicare, Medicaid, Aetna, Humana, and United Health Care)
  • Checked in 60-80 patients per day
  • Handled 100+ inbound calls per day

Overview

16
16
years of professional experience

Work History

Member Service Representative

Premera Blue Cross Of Washington
10.2023 - 05.2025
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
  • Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
  • Maintained high-quality service by adhering to company policies and standards in all member interactions.
  • Verified customer identification and documentation for compliant transactions.
  • Consistently met or exceeded performance metrics through proactive management of workload and effective prioritization.

Patient Access

Optum
07.2019 - 10.2023
  • Maintain and update current information on physicians’ schedules ensuring that patients are scheduled properly.
  • Accurately answer questions or guide in the right direction regarding patient appointments, prescriptions, testing, etc.
  • Create, maintain, and update patient records and associated schedules.
  • Participates in all other communal job duties necessary for functioning of the office. Attend meetings as required.
  • Perform other duties as assigned.
  • Follow compliance requirements and determine by the organization.
  • Conduct follow-up phone calls to patients, providers, physicians, adjustors, and other parties as needed; recognizing and resolving customer issues in a timely manner and escalating to leadership only as necessary.
  • Maintains patient privacy and confidentiality under requirements of federal and state laws, including HIPAA, and in accordance with company policy.
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues.

Specialist Pharmacy

Alliance Rx Walgreens Prime
10.2017 - 03.2019
  • Provided new and existing patients with the best possible customer service in relation to their drug prescriptions, clinical services, billing inquiries, patients’ suggestions and complaints.
  • Recorded and processed orders and/or inquiries received by fax, mail, telephone, and/or through patient direct contact.
  • Received inbound and outbound calls to patients or MD Offices regarding orders for medications, pharmacy services and all other inquiries.
  • Coordinated patient care by scheduling orders, communicating information to the patient regarding shipments, assessing supply needs, verifying patient information, notifying the pharmacist of issues or changes in the patient’s condition.
  • Provided patient activities as a reminder for the following tasks including but not limited to follow-up calls for patients, to initiate discharge of service, to contact a patient's doctor's office, to mail a letter to a patient, and any other reminders necessary as it relates to a patient's care.
  • Contacted the pharmacists to alert them of any changes in patient's condition, compliance issues due to patient not taking medication or side effects, or to transfer a patient directly to pharmacist for counseling.
  • Completed other stages of the order process as assigned including but not limited to scanning prescriptions, imagine indexing, preQA, load insurance information, run test claims, work issues and facilitate prior authorizations.

Customer Service Representative

Bank of America
03.2009 - 06.2017
  • Answered Inbound/Outbound calls from own personal customers; seeking modification for home, discuss missing or incomplete documents on weekly basis.
  • Made follow up calls every 3-5 business days about the status of the loan modification.

Education

High School Diploma - undefined

Estacado High
Lubbock, TX
01.1986

Skills

  • Customer service
  • Relationship building
  • Customer support
  • Call center experience
  • Dispute resolution
  • Issue resolution
  • Escalation handling
  • Complaint handling
  • Document processing
  • Membership renewals
  • Healthcare
  • Calm and professional under pressure
  • Teamwork and collaboration
  • Microsoft office
  • Customer relationship management (CRM)
  • Data entry

Languages

English
Full Professional

Timeline

Member Service Representative

Premera Blue Cross Of Washington
10.2023 - 05.2025

Patient Access

Optum
07.2019 - 10.2023

Specialist Pharmacy

Alliance Rx Walgreens Prime
10.2017 - 03.2019

Customer Service Representative

Bank of America
03.2009 - 06.2017

High School Diploma - undefined

Estacado High

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Shirl Byrd