Summary
Overview
Work History
Education
Skills
Timeline
Generic

Sierra Johnson

Sacramento

Summary

I am an experienced healthcare customer service representative with a strong background in managing patient inquiries,insurance verification, and navigating complex healthcare systems. I am keen to apply my strong work ethic and willingness to learn to contribute to a team, while gaining hands-on experience and developing skills in utilization management and patient care coordination.

Overview

11
11
years of professional experience

Work History

Customer Service Representative

RCMG
03.2024 - Current
  • Providing members eligibility details
  • Resolving issues and complaints related to medical care, insurance, and other healthcare service
  • Checking patient demographics, insurance details, and other relevant information.
  • Communicating effectively with patients, providers, and insurance companies.
  • Updating member demographics and adding member to the portal
  • Recreating authorizations and routing them to proper queues.

Customer Service Representative/ Chat Support

TTEC
08.2021 - 03.2024
  • Answer incoming communication from customers.
  • Conduct research to provide answers for customer to resolve their issues.
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
  • Developed strong product knowledge to provide informed recommendations based on individual customer needs.

Customer Service Representative/Team Lead

Faneuil (Blue Cross Blue Shield Of Michigan)
11.2019 - 08.2021
  • Respond to a high volume of inbound calls in a call center environment
  • Provide assistance to members regarding website registration and navigation
  • Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries
  • Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment
  • Handled escalated and complex inquiries from members and regarding claims, eligibility, covered benefits and authorization status matters

Customer Service Representative

Kelly Services ( Health Net/Centene)
05.2019 - 09.2019
  • Provide assistance to members and/or providers regarding website registration and navigation
  • Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner
  • Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries.
  • Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application

Customer Service Representative/Team Lead

Faneuil (CoveredCA)
09.2017 - 01.2019
  • Received inbound and outbound calls while enrolling consumers
  • Responsible for de escalating phone calls
  • Responsible for handling escalated cases in a timely manner into health plan
  • Provide professional etiquette via phone, chat, email communications
  • One call resolution belief
  • Provided excellent customer service
  • Provide leadership, guidance and continuous mentoring to Customer service team

Medical Assistant/ Front Office

Family Planning Associates
11.2016 - 07.2017
  • Schedule and reschedule patients appointments
  • Take and record patients vitals
  • Answer telephone and guide callers regarding medical procedures
  • Ensure completeness and accuracy of patient’s insurance forms prior to submitting

Caregiver

Greenhaven Estates
06.2016 - 11.2016
  • Assist residents with daily living activities such as grooming, showering, and dressing
  • Assess residents’ medical needs and monitor changes in their health
  • Transport and transfer residents from wheelchair to activities
  • Ability to effectively communicate with clients and their families.
  • Providing emotional support, engaging in activities, and fostering a positive atmosphere.

Customer Service Representative

Apple One (Maximus)
10.2014 - 01.2016
  • Provided excellent customer service
  • Received inbound and outbound calls while enrolling beneficiaries into their MCP (managed care plans)
  • Managed and resolved the beneficiary’s complaint while routing calls to the proper queue

Education

Medical Assistant Certificate -

10-2016

High School Diploma -

Hiram Johnson High School
Sacramento, CA

Skills

  • Adaptability
  • Active listening
  • Critical thinking
  • Strong leader
  • Problem solver
  • Chat Support
  • Ability to Multi-task
  • Effective Team Player
  • Detail Oriented
  • Excellent Interpersonal Skills
  • Administrative Skills
  • Improving Customer Satisfaction
  • Efficient workspace management
  • Data Entry: Typing speed of 45 wpm
  • Microsoft Excel, Word, & Outlook
  • Multi Line Telephone

Timeline

Customer Service Representative

RCMG
03.2024 - Current

Customer Service Representative/ Chat Support

TTEC
08.2021 - 03.2024

Customer Service Representative/Team Lead

Faneuil (Blue Cross Blue Shield Of Michigan)
11.2019 - 08.2021

Customer Service Representative

Kelly Services ( Health Net/Centene)
05.2019 - 09.2019

Customer Service Representative/Team Lead

Faneuil (CoveredCA)
09.2017 - 01.2019

Medical Assistant/ Front Office

Family Planning Associates
11.2016 - 07.2017

Caregiver

Greenhaven Estates
06.2016 - 11.2016

Customer Service Representative

Apple One (Maximus)
10.2014 - 01.2016

Medical Assistant Certificate -

High School Diploma -

Hiram Johnson High School