Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options. Knowledgeable and dedicated customer service professional with extensive experience in the Healthcare & Banking industries. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Customer Service Rep
TD BANK
10.2022 - Current
Delivers legendary Customer Experience while providing solutions and referrals for TD products and services to new and existing Customers
Consistently executes appropriate behaviors to deliver Legendary Customer experience in Store
Conducts needs-based conversations and offers financial solutions to meet Customers' needs
Makes quality referrals to appropriate partners
Responsible for meeting individual performance metrics
Responsible for making sound decisions and timely problem resolution
Proactively reaches out to Customers to deepen relationships through needs-based conversations
Performs broad range of tasks of varying complexity and scope
Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Handled customer inquiries and suggestions courteously and professionally.
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Offered advice and assistance to customers, paying attention to special needs or wants.
Participated in team meetings and training sessions to stay informed about product updates and changes.
Utilized customer service software to manage interactions and track customer satisfaction.
Analyzed customer service trends to discover areas of opportunity and provide feedback to management.
Investigated and resolved customer inquiries and complaints quickly.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Met customer call guidelines for service levels, handle time and productivity.
Educated customers about billing, payment processing and support policies and procedures.
Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
Enhanced productivity levels by anticipating needs and delivering outstanding support.
Answered customer telephone calls promptly to avoid on-hold wait times.
Updated account information to maintain customer records.
Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Exhibited high energy and professionalism when dealing with clients and staff.
Responded to customer requests, offering excellent support and tailored recommendations to address needs.
Maintained up-to-date knowledge of product and service changes.
Sought ways to improve processes and services provided.
Managed over 50 customer calls per day.
Offered advice and assistance to customers, paying attention to special needs or wants
Client Relationship Associate
VANGUARD
01.2022 - 09.2022
In FINRA licensure training to be able to answer all incoming Financial Advisors' phone calls and handle as appropriate while learning when to schedule client appointments
Ability to have direct ownership of Number of existing client relationships and serve as primary contact on their investments
Proactively service clients to provide resolution to broad range of investment-related queries
Develop relationships and work closely with internal stakeholders on behalf of clients, including portfolio management, legal, compliance, operations and reporting teams
Studying to align actions to customer needs, identify customer needs through financial need analysis /investment profile review, and offer differentiated solutions of banking and wealth management products /services in line with customers’ changing profile and needs, also attending to their needs and requests
Maintaining and developing relationships with clients understanding and helping to address their individual investment needs
Developed summaries to assess each client's participation level and determine targets for follow-up plans.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Used consultative sales techniques to understand customer needs and recommend relevant products and services.
Generated status reports, brief books and IPO pitches.
Helped clients make informed decisions about financial future.
Educated clients on potential risks and rewards associated with various investments.
Educated clients on financial topics and best practices.
Researched current economic trends and investment opportunities to stay abreast of financial markets.
CAREMETX-Reimbursement Specialist
RANDSTAD STAFFING
01.2021 - 01.2022
Provides exceptional customer service to internal and external customers; resolves any customer requests in timely and accurate manner; escalates complaints accordingly
Exercises judgment within defined standard operating procedures to determine appropriate action
Collects and reviews all patient insurance benefit information, to degree authorized by SOP of program
Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications
Completes and submits all necessary insurance forms in timely manner as required by all third-party payors for prior authorizations
Tracks and follow up on prior authorization request
Maintains frequent phone contact with provider representatives, third party customer service representatives, and pharmacy staff
Reports any reimbursement trends/delays to supervisor.
Followed up on denied and unpaid claims to resolve problems and obtain payments.
Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
Delivered timely information to insurance representatives to resolve common and complex issues.
Helped minimize escalations by reaching out to clients in advance of expected problems.
Created documents in accordance with payer guidelines and submitted to appropriate parties.
Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
Built proactive, client-specific edits into system to prevent future denials.
Used data entry skills to accurately document and input statements.
Audited and corrected billing and posting documents for accuracy.
Monitored outstanding invoices and performed collections duties.
Utilized various software programs to process customer payments.
Works on problems of moderate scope where analysis of data requires review of variety of factors
Followed up on denied and unpaid claims to resolve problems and obtain payments
Coordinated with insurance providers to verify customer's policy benefits in relation to claims
Delivered timely information to insurance representatives to resolve common and complex issues
Helped minimize escalations by reaching out to clients in advance of expected problems
Contributed knowledge to help improve financial management, billing and tracking systems
Unemployment Benefit Specialist
ADECCO STAFFING, State of Maryland
01.2020 - 01.2021
Managed over 50 customer calls per day.
Receive, track and respond within time limits to all Unemployment Claims
Communicate with clients via phone & e mail to obtain detailed separation information from former employee
Make decisions from client information as to best or most successful response to each claim
Receive determinations on claims & requests appeals as appropriate/necessary
Response/protest incorrect charges from state
Respond to client questions & requests related to State Unemployment processes and requirements
Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
Analyzed and reported on employee benefits data to identify trends and develop strategies for improvement.
Coordinated and conducted employee orientations to promote understanding of coverage and options.
Checked employees' benefits enrollment for accuracy and inputted all data into government software.
Gathered information about each position and related occupation with employee interviews, field observations, and industry research
Help create and optimize salary structures and bonus programs
Created detailed job description library for organization and maintained relevance with regular updates
WORKER'S COMP LIAISON
RANDSTAD STAFFING
01.2020 - 01.2021
NC Eastern Region Risk Management Liaison (Worker's Comp)- REMOTE
Monitors and analyzes risks within company's employees and reports on these risks to Risk Management team consisting of Directors and Branch Managers while providing key inputs into company's Covid enterprise risks, to staff, as well as AVP who oversees enterprise risk management process and ensures alignment with organizational objectives
Support strategic partnerships by providing top-quality advice, facilitating effective knowledge management, and providing coordination, monitoring and reporting in any collaborations.
Networked with local organizations, leaders, and consumers, resulting in establishment of new and lasting partnerships and relationships.
Communicated with community members to assess concerns or current issues and identify corrective measures.
Developed long-lasting partnerships with local leaders, management team and peers with active engagement, exemplary communication and consistent issue resolution.
Surveyed local program participants to ascertain problematic areas requiring improvement.
Assisted in conducting needs assessments to identify key areas of service needs.
Facilitated outreach activities to build community awareness.
Facilitated communication between clients and other service providers.
Provided support to social service clients in navigating available resources.
Spoke with senior citizen groups to expand community engagement and program outreach.
Developed and maintained accurate records of programs and services.
Developed and maintained relationships with community organizations and agencies.
Communicated with community members to assess concerns or current issues and identify corrective measures
Networked with local organizations, leaders, and consumers, resulting in establishment of new and lasting partnerships and relationships
Developed long-lasting partnerships with local leaders, management team and peers with active engagement, exemplary communication and consistent issue resolution
Developed and maintained relationships with community organizations and agencies
Referral Specialist I
CENTENE/CAROLINA COMPLETE HEALTH
01.2019 - 01.2020
Demonstrated knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization, while maintaining patient confidentiality
Familiarized with procedures completed in office with attention to detail and ability to catch mistakes
Completed 30-35 referrals and prior authorizations, daily, and in timely manner according to guidelines and workflows
Communicated clearly and effectively with patients, physicians, office staff and manager to resolve issues that may result in denied or delayed authorization request
Demonstrated complete system knowledge, ability to run reports, document and manage referrals and authorizations, to resolve eligibility and authorization holds
Demonstrated ability to request, prepare and recognize documentation required to support medical
Necessity for service being authorized with support from each Medical Director
Provided supervisor and manager with immediate feedback on issues affecting workflow, reimbursement, and customer service
Ensured appropriate and accurate information was entered in patient account
Collaborated with team members to meet department deadlines and benchmarks.
Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Called insurance companies to get precertification and other benefits information on behalf of patients.
Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
Built professional relationships with service providers.
Verified insurance benefits and eligibility for procedures before referring clients.
Obtained prior authorization for procedures.
Coordinated with medical staff and patients to find cost-effective options for services.
Accessed and reviewed patient records to verify receipt completed referral paperwork.
Assisted with completion of referral forms and verified data accuracy and completion
Developed and maintained strong working relationship with referral sources to streamline processing.
Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
Performed various administrative tasks by filing, copying and faxing documents.
Attended continuing education courses to stay current on referral processes and best practices.
Completed administrative patient intakes with case histories, insurance information and mandated forms.
Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Prepared and processed patient referrals and transfer requests.
Registered and verified patient records before triage with most up-to-date information.
Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process
Human Resource Generalist
PIONEAR RECRUITING
01.2019 - 01.2019
Prepared paperwork, scheduled and facilitated smooth new hire onboarding process and coordinated with cross-functional departments to deliver exceptional first-day experience
Handled administrative tasks for onboarding, new hire orientation and exit interviews, including entering data into HR information systems and auditing for accuracy and compliance
Assisted with recruitment process by identifying candidates, conducting reference checks and issuing employment contracts
Handled variety of different clientele through various levels of communication, from college deans to independent contractors.
Provided guidance to managers and employees on talent management, payroll, FMLA and benefits.
Handled new-hire orientation and basic recruiting tasks for best-in-class talent identification.
Facilitated criminal background check process for new hires.
Understood, interpreted and mediated human resources inquiries to support administration of human resources policies, procedures and programs.
Explained and administered medical insurance, disability and flexible spending accounts.
Processed unemployment claims and acted as company representative at unemployment hearings.
Conducted career fairs, screened resumes and interviewed applicants to build candidate pipelines and enhance company culture.
Developed and enforced company policy and procedures relating to human resources activity.
Collaborated with payroll to complete and upload pay data and worked with managers to support proper wage and hour compliance.
Provided job placement accommodation recommendations for employees on physician-mandated medical restriction.
Patient Representative
CHARLOTTE, EYE, EAR, NOSE & THROAT ASSOCIATES
01.2017 - 01.2019
Generated and identified patient information necessary for office visit, including demographics and insurance information, along with charge posting and collected balances from patients, educated patients on payment expectations and arrangements and entered in EPIC system
Managed communication from patients by phone, internet or other correspondence to schedule and/or confirm patient appointments to ensure admittance in timely manner
Reached and maintained 97% satisfaction rating over 24-month period as customer care representative and received several PICKLE Awards for Outstanding Customer Service.
Verified any changes or data updates to patient records and checked insurance information at each appointment.
Observed all facility rules and regulations regarding patient data to promote confidentiality and integrity.
Scheduled appointments for patients and placed reminder calls 48 hours before office visits
Monitored patient flow throughout day to maintain appointment times and schedules.
Informed patients of excessive wait times and offered to reschedule appointments.
Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
Answered patient assistance calls, assessed needs, and offered qualified support.
Supported patient admissions, discharges, and transfers to promote team productivity.
Used principles of growth and development to provide age-specific treatment and care.
Answered incoming calls, scheduled appointments and filed medical records.
Verified patient insurance eligibility and entered patient information into system.
Provided excellent customer service to patients and medical staff.
Processed payments using cash and credit cards, maintaining accurate records of transactions.
Facilitated communication between patients and various departments and staff.
Followed document protocols to safeguard confidentiality of patient records.
Applied administrative knowledge and courtesy to explain procedures and services to patients.
Responded to inquiries by directing calls to appropriate personnel.
Compiled and maintained patient medical records to keep information complete and up-to-date.
Engaged with patients to provide critical information.
Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Delivered support to medical staff in completion of patient paperwork.
Organized patient records and database to facilitate information storage and retrieval.
Worked with patients to ascertain issues and make referrals to appropriate specialists.
Manager of Recruitment
AMERICAN INCOME LIFE
01.2017 - 01.2017
Spearheaded search for potential candidates, set interview appointments and assessed team members for strengths and development; followed up with secondary appointments as needed
Diagrammed, developed and Introduced new document management system with new innovative spreadsheet template for better tracking of employees on-boarding process
Authored and Improved marketing campaign, strategies and budgets for employment fairs and seminars.
Conducted phone interviews to assess applicants relevant knowledge, skills, experience and aptitudes.
Built strong relationships with internal and external candidates to ensure excellent hiring experience.
Achieved staffing objectives through strategic and tactical planning, program management expertise and knowledge of effective recruitment, interviewing and training procedures.
Met with managers to discuss vacancies, applicant qualifications and characteristics of top candidates.
Customized wording of job profiles, social media techniques and website subscriptions.
Developed comprehensive process for new hires and reviewed new hire productivity, optimizing onboarding effectiveness.
Discovered and resolved complex employee issues that affected management and business decisions.
Facilitated successful policy implementation and enforcement to maintain legal and operational compliance.
Devised hiring and recruitment policies for 50 person employee company
Designed, developed and implemented successful recruitment process to fill more than 30 vacancies each year
Built strong relationships with internal and external candidates to ensure excellent hiring experience.
Collaborated with internal teams to continuously improve recruitment processes and execute as efficiently as possible.
OptumRx Mail Order Agent
UNITED HEALTH GROUP
01.2016 - 01.2017
Processed orders directly to designated policy or procedure; advised of any changes or impact and demonstrated ability to comprehend complex Medicare programs in order to explain/articulate programs to callers.
Double-checked customer orders and information before filling out order forms to prevent unnecessary delays and errors.
Processed and handled customer complaints, answering questions and providing alternative solutions.
Utilized customer service software to accurately enter customer data, process orders and update customer records.
Skilled at working independently and collaboratively in team environment.
Self-motivated, with strong sense of personal responsibility.
Proven ability to learn quickly and adapt to new situations.
Managed time efficiently in order to complete all tasks within deadlines.
Passionate about learning and committed to continual improvement.
Adaptable and proficient in learning new concepts quickly and efficiently.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Identified issues, analyzed information and provided solutions to problems.
Communicated with customers to verify information, fill out appropriate paperwork and carry out specified requests.
Site Coordinator
LASH GROUP
01.2015 - 01.2016
Ensured completeness and submitted required insurance and electronic claim forms to process insurance, and researched and resolved any claim denials or underpayment of claims or resolved enrollment errors and issues
Aided physician office staff and patients to complete and submit all necessary insurance forms.
Supervised crew of over 5 employees.
Coordinated site investigations, documented issues, and escalated to executive teams.
Screened patient records, databases, and physician referrals to identify prospective candidates for research studies.
Worked with principal investigator and sponsors to facilitate daily trial activities and comply with research protocols.
Benefit Investigation Verification Specialist
LASH GROUP
09.2009 - 12.2015
Simplified routine healthcare benefits and beneficiary questions and probed for other related issues about products or services from customers via Live Support web chat, email, inbound and outbound calls while processing enrollment
Researched, processed and resolved any claim denials or underpayment of claims for patient’s home/office infusion therapy and any necessary insurance/patient correspondence providing documentation required to expedite payments.
Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
Observed strict procedures to maintain data and plan participant confidentiality.
Built relationships with vendors to foster quality service delivery.
Reduced employee turnover by creating welcoming, inclusive and employee-centered work culture.
Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions
Systems Analyst
WELLS FARGO - WACHOVIA BANK
01.2009 - 01.2010
Conceptualized bank project-oriented work efforts in areas of technical problem identification, resolution, performance, and supported business development processes and performed project roles
Created relational databases and mainframe applications and gathered documents and statistics, records, and reports by micromanaging from home with use of corporate laptop to continue workload after hours if needed.
Performed system analysis, documentation, testing, implementation, and user support for platform transitions.
Resolved or escalated problem tickets to resolve user issues.
Diagnosed, troubleshot and resolved network and system problems.
Resolved malfunctions with systems and programs through troubleshooting.
Investigated system issues and implemented resolutions to reduce downtime.
Analyzed existing systems and databases and recommended enhancements to solve business needs
Performed internal system acceptance to deliver well-tested enhancements and meet business requirements.
Offered input for complex documents to support client-ready final versions.
Oversaw document development across project workstreams to create internal control statements per compliance and regulatory standards.
Assessed business requirements to create focused solutions
Installed system updates to address vulnerabilities and reduce security issues
Online Access Rep/Phone Banker
WACHOVIA/WELLS FARGO BANK
12.2005 - 10.2008
Provided immediate response to complex issues of premier customers over phone and performed research as required to resolve customer issues
Maintained knowledge of all customer requirements and provided appropriate responses
Administered processing of all transactions accurately and within required time frame
Informed clients of any additional new products and services of bank.
Stayed current on changing products, services and policies to offer exceptional service to customers.
Improved customer satisfaction by going above-and-beyond to answer questions and offer expert support.
Helped customers complete online banking services and assisted with user access problems such as forgotten passwords.
Upheld strict security procedures to verify identities when completing actions for members and giving out private banking information.
Completed transactions for customers and capitalized on opportunities to cross-sell products and services.
Used CRM system daily to maximize service opportunities and enhance communication.
Alleviated call loads by educating customers about how to effectively navigate site tools and pages for future banking needs.
Responded to customer inquiries regarding new accounts and account services.
Provided customers with additional information regarding account services.
Associate of Arts - Criminal Justice; Business Administration
DeVry University
ONLINE
2012
Certificate of Completion, Medical Office Practices & Procedures/Medical Terminology -
Central Piedmont Community College
Charlotte, NC
2000
High School Diploma -
West Mecklenburg High School
Charlotte, NC
Skills
Fleet Dispatching
Report Preparation
Business Development Understanding
Microsoft PowerPoint
Order Fulfillment
Customer Relations
Report Creation
Credit Card Payment Processing
Active Listening
Microsoft Excel
Lotus Notes
Microsoft Word
Senior Leadership Support
Microsoft Windows
Time Management
Administrative Support
Investigate Claims
Process Transactions
Recordkeeping Strengths
Microsoft Access
Quality Assurance Controls
Customer Service
Social Perceptiveness
Clerical Support
Issue and Complaint Resolution
Product Promotion
Training Development Aptitude
Receiving Support
Refund Processing
Conflict Resolution
Order and Refund Processing
Customer Relationship Management
Document Control
Schedule Mastery
Managing Multiple Tasks
Service Standard Compliance
Adobe Systems Adobe Acrobat
Oracle EnterpriseOne
Promotional Support
System Implementation
Tax Software
Microsoft Internet Explorer
Oracle PeopleSoft
Google Docs
Order Processing
Multi-Line Telephone Operation
Strong Analytical and Problem-Solving Skills
Multi-Line Phone Talent
Call Volume and Quality Metrics
Technical Support
Medical Terminology Knowledge
Computer Proficiency
Grammar
Coordination
Research
Filing
Prioritization
Monitoring
LinkedIn
Service-Orientation
10-Key
Calendaring
LexisNexis
Facebook
SAP
Efficient customer service expert
Customer service, education and counseling
Customer service optimization
Personalized customer service
Customer service awareness
Accomplishments
Supervised team of 5 staff members.
Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.
Customer Follow-up - Ensured that customers were satisfied with company products and services by doing purchase follow-up calls.
Telephone Service - Professionally processed 80+ calls per day, providing information and service to ensure customer satisfaction.
Certification
OVATION| FINESSE| NET IQ| CITRIX| CORE| RETAIL ONE|FINRA SIE Studies|CPR Certified | Tru-Care | EPIC Systems | Patient Plus
Group Cast | Legend | MS Office Edge & 365 | HIPAA & PHI Compliant | Insurance Processing & Reimbursement | Billing and Claims Processing | Documentation Review | TLO / XP -TransUnion | Taleo-Applicant Tracking Software | Lexis-Nexis | Accurint-Background Checks| Medical Billing Software | Client Central Payments Processing | Marketing | Business Relationship Building | Social Media Aptitude