Siera McCummings
Clayton,NC
Summary
13+ years of experience as a customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound calls and sustaining satisfactory relationships with customers. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.
Overview
14
14
years of professional experience
Work History
Customer Service Representative II
Duke Energy
Raleigh, NC
10.2019 - 09.2024
- Assist customers through support channels, including phone, chat and/or email, to assist with payments, resolve billing and credit issues
- Provide high quality customer interaction by handling customer’s needs with integrity and empathy in one transaction
- Exhibit good decision-making skills and anticipating customer needs while efficiently providing accurate information
- Offer and educate customers on various company products and services
- High degree of accountability for individual performance in the areas of customer satisfaction, quality, and productivity to ensure that customers receive excellent service
- Offer solutions to customers who needed assistance with electric bill
- Handle about 80-100 calls per shift on average
- Maintained detailed records of customer interactions, transactions and comments for future reference.
Reimbursement Specialist/ Patient Care Coordinator
TrialCard - Janssen
Morrisville, NC
04.2016 - 09.2019
- Responsible for handling the day-to-day activities within reimbursement services (benefits investigation, prior authorizations and appeals support)
- Complete medical and/or pharmacy benefit investigations, identify and facilitate submission of required documentation for payer/plan review for prior authorization
- Responsible to determine coverage availability and coordinate the financial aspects of healthcare services to ensure patients have access to prescribed therapy
- Partner with patient care coordinator to serve as an advocate to patients and healthcare professionals regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals.
- Reviewed and processed reimbursement requests in accordance with company policies and procedures.
- Analyzed patient data to ensure accuracy of reimbursement information.
- Maintained a database of all reimbursements, payments, and other transactions.
Customer Service Representative
NC MEDICAID
Raleigh, NC
01.2011 - 03.2016
- Answered customer inquiries and provided accurate information regarding products and services.
- Assist recipients with verifying coverage
- Educate customers on plan types and coverage
- Update and confirm Primary Care Providers
- Assist providers with inquires about procedure codes (CPT) used to report medical services for reimbursement
- Maintained up-to-date knowledge of customer accounts
- Confirmed payments, refunds, etc
- Set goals to achieve as a way to spur performance and to measure effectiveness.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Upheld quality control policies and procedures to increase customer satisfaction.
Education
High School Diploma -
Wake Technical Community College
Raleigh, NC02.2012
Skills
- Call Center
- CPT codes
- Data Collection
- Technical Support
- Medical Records
- Insurance Verification
- Salesforce
- SharePoint
- Customer Support
- CRM Software (Customer Relationship Management)
- Analysis Skills
- Accounting
- Accounts Receivable
- Accounting Software
- Call Management
- Report Generation
- Information Security
- Product Knowledge
- Account updating
- Inbound and Outbound Calling
- Data Entry
- Dispute Resolution
- Microsoft Office expertise
- Office equipment proficiency
Timeline
Customer Service Representative II
Duke Energy
10.2019 - 09.2024
Reimbursement Specialist/ Patient Care Coordinator
TrialCard - Janssen
04.2016 - 09.2019
Customer Service Representative
NC MEDICAID
01.2011 - 03.2016
High School Diploma -
Wake Technical Community College