Summary
Work History
Education
Skills
Timeline
Generic

SONIA REDHOUSE

GLENDALE

Summary

Customer Service Professional with over 9 years of experience in Medicare claims processing and retail environments. Demonstrates expertise in customer service, claims resolution, and inventory management, fostering operational efficiency and client satisfaction. Adept at leveraging communication skills to guide clients through complex processes, enhancing service inclusivity and trust.

Work History

CLAIMS PART B CUSTOMER SERVICE REPRESENTATIVE 1

Vangent
03 2004 - 07 2009
  • Maintain a current understanding of the processing procedures to respond to numerous phone inquiries
  • Provide information on Medicare Managed Care Plans and Medigap options available in specific geographic areas
  • Disenroll beneficiaries who no longer want their health plan or prescription drug coverage or wish to opt-out from autoenrollment
  • Send disenrollment confirmation letters
  • Respond to requests for status check of a previous Disenrollment
  • Look at claims information and tell why Medicare didn't pay or order a replacement notice
  • Provide General Claims information
  • Teletype or text typewriter (TTY) trained

CUSTOMER SERVICE REPRESENTATIVE TIER 11

Vangent
01 2004 - 07 2009
  • Addressed Part B claims inquiries, enhancing customer satisfaction through clear guidance.
  • Clarified Part B coverage details, improving client understanding and reducing follow-up queries.
  • Resolved claim denials, resulting in improved claim approval rates and customer trust.
  • Explained status and location codes, aiding in efficient claims processing and accuracy.
  • Collaborated with team to streamline processes, supporting operational efficiency.
  • Expertly handled Part B Claims inquiries, leveraging NGD scripts to provide accurate information on coverage, pricing, and claim denials.
  • Mastered internal control numbers (ICNs), status codes, and location codes, ensuring precise tracking and explanation of claim processes.
  • Guided clients through complex Medicare processes, clarifying Part B coverage limitations and local carrier jurisdictions.
  • Guided clients through intricate Part B coverage limitations and local carrier jurisdictions, reducing follow-up queries and building trust.
  • Leveraged NGD scripts to provide accurate information on coverage and pricing, significantly reducing follow-up queries and building client trust.
  • Mastered intricate Medicare regulations, ensuring accurate guidance on coverage limitations and local carrier jurisdictions.
  • Guided beneficiaries through disenrollment processes, ensuring smooth transitions and addressing concerns with empathy and clear communication.
  • Utilized TTY technology to expand accessibility, enabling effective communication with hearing-impaired beneficiaries and improving service inclusivity.
  • Facilitated seamless transitions for beneficiaries during disenrollment, addressing concerns empathetically and ensuring clear communication throughout the process.
  • Worked closely with team members to provide comprehensive information on Medicare Managed Care Plans and Medigap options, tailored to specific geographic areas.
  • Streamlined disenrollment processes, reducing processing time and ensuring smooth transitions for beneficiaries opting out of health plans.

CUSTOMER SERVICE REPRESENTATIVE

Dillard's
01 2002 - 02 2004
  • Provide customer service to people who are looking for clothes
  • Helped do inventory of store merchandise
  • Put stock on display for customers to see what we had available
  • Work with cash register handling cash, checks, credit cards and store credit cards

SALES CONSULTANT

American Home Furniture
01 2000 - 01 2002
  • Provide customer service to people who are looking for house-wares, bath linens, bedroom linens, and carpet
  • Helped customer decide what would look nice in their home
  • Ordered items for customers if we were out of stock
  • Helped do inventory of store merchandise
  • Work with cash register handling cash, checks, credit cards and store credit cards
  • Register couples for weddings or open houses

PBX OPERATOR/ FRONT DESK

Holiday Inn Select Airport
01 2000 - 05 2000
  • Answered incoming calls and transferred them to the right room or department
  • Made or cancelled reservations for guest
  • Checked in and checked out guest

Education

HIGH SCHOOL DIPLOMA -

Kirtland Central High School
Kirtland, NM
01.1995

Skills

  • Customer Service
  • Medicare
  • Claims Processing
  • Inventory Management
  • Sales
  • Cash Handling
  • Reservation Management
  • PBX Operation

Timeline

CLAIMS PART B CUSTOMER SERVICE REPRESENTATIVE 1

Vangent
03 2004 - 07 2009

CUSTOMER SERVICE REPRESENTATIVE TIER 11

Vangent
01 2004 - 07 2009

CUSTOMER SERVICE REPRESENTATIVE

Dillard's
01 2002 - 02 2004

SALES CONSULTANT

American Home Furniture
01 2000 - 01 2002

PBX OPERATOR/ FRONT DESK

Holiday Inn Select Airport
01 2000 - 05 2000

HIGH SCHOOL DIPLOMA -

Kirtland Central High School

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