Theresa Alexander
Columbus
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty. Willing to relocate: Anywhere
Overview
14
14
years of professional experience
2
2
years of post-secondary education
1
1
Certification
Work History
Benefits Verification Specialist
MMC Group
DeMotte
10.2025 - Current
- Conducted thorough benefits verification for patient eligibility and coverage details.
- Collaborated with healthcare providers to gather necessary documentation for claims processing.
- Utilized electronic health record systems to ensure accurate data entry and management.
- Communicated with insurance companies to resolve discrepancies in benefit information.
- Maintained up-to-date knowledge of healthcare regulations and policy changes impacting benefits.
- Documented verification processes in compliance with organizational policies and procedures.
- Adhered to HIPAA regulations when handling confidential patient information.
- Attended training sessions on new policies or procedures related to benefit verifications.
Health Care Assistant
Private Home - Elderly Care
Columbus
09.2014 - 11.2025
- Communicated effectively with family members regarding client needs.
- Assisted elderly clients with daily living activities and personal care.
- Provided companionship and emotional support to enhance well-being.
- Maintained a clean and safe environment in private home settings.
- Coordinated medication schedules to ensure timely administration.
Customer Service Representative - Contractor
Chenega Professional & Technical Services
DeMotte
04.2025 - 07.2025
- Provided exceptional customer service to assist clients with inquiries and issues.
- Resolved complex customer complaints by employing problem-solving techniques effectively.
- Collaborated with team members to improve service delivery and operational processes.
- Utilized Salesforce software to track customer interactions and maintain accurate records.
- Handled escalated issues by coordinating with management for timely resolutions.
- Resolved customer complaints promptly and efficiently.
Case Manager
MMC Group Professional Staffing - Company Cencora
09.2024 - 03.2025
- Approving patients for the Patient Assistance Program (PAP) for patients that meet Federal Guide lines, Salesforce proficient, data intake, detail oriented, participated in the launch of the new Icare system, data entry, customer service.
Customer Service Representative
Dawson/Spinlife
Columbus
09.2023 - 11.2023
- I was a customer service representative for a Durable Medical equipment company
- I took inbound and outbound calls
- I assisted customers with their order status and also tracking their orders, i performed data entry, responded to customer emails and also Triage calls.
Recruitment Specialist
Manpower/Fedex Express
08.2022 - 07.2023
- ATS, In-person customer service, phone screening, scheduling interviews, updating client information, facility tours, background checks and drug screening.
Medicaid Member Services Representative
Molina Healthcare
10.2020 - 10.2021
- Communicating with members regarding their Medicaid accounts, assisting members with account issues, appeals and grievances, ID cards, scheduling transportation, billing inquiries, claim issues, benefits, authorizations, pharmacy inquiries.
Customer Service Representative
Healthcare Support Staffing
06.2020 - 10.2020
- Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints
- Check to ensure that appropriate changes were made to resolve customers' problems
- Refer unresolved customer grievances to designated departments for further investigation
- Review insurance policy terms to determine whether a particular loss is covered by insurance
- Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
- Handle and submit customer grievances and appeals, dispute billing issues, provide assistance with medical and pharmacy claims, prior authorizations.
Transportation Driver
Uber
05.2017 - 06.2020
- Follow relevant safety regulations and state laws governing vehicle operation and ensure that passengers follow safety regulations
- Test vehicle equipment such as lights, brakes, horns, or windshield wipers, to ensure proper operation
- Arrange to pick up particular customers or groups on a regular schedule
- Provide passengers with assistance entering and exiting vehicles, and help them with any luggage
- Notify dispatchers or company mechanics of vehicle problems
- Complete accident reports when necessary
- Communicate with dispatchers by radio, telephone, or computer to exchange information and receive requests for passenger service
- Drive taxicabs, limousines, company cars, or privately owned vehicles to transport passengers
- Perform routine vehicle maintenance such as regulating tire pressure and adding gasoline, oil, and water.
Customer Care Representative II
Anthem Blue Cross Blue Shield
01.2019 - 12.2019
- Review insurance policy to determine coverage
- Post or attach information to claim file
- Transmit claims for payment or further investigation
- Contact insured or other involved persons to obtain missing information
- Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints
- Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
- Check to ensure that appropriate changes were made to resolve customers' problems
- Refer unresolved customer grievances to designated departments for further investigation
- Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
- Hear and resolve complaints from customers or the public
- Taking inbound calls from health insurance customers, responding to inquiries and resolving minor to complex issues
- Assisting members with claims, grievances and appeals, pharmacy issues and prior authorizations.
Customer Care Representative II
Anthem Blue Cross Blue Shield
02.2016 - 06.2018
- Taking inbound calls in a call center setting, providing resolution to member/customer issues
- Assisting customers with claims, billing, grievances and appeals, account documentation, researching complex issues, ordering member ID cards, and performing provider searches per member request
- Consulting with providers member/customer issues.
Customer Service Representative
Kelly Services
11.2015 - 02.2016
- Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints
- Check to ensure that appropriate changes were made to resolve customers' problems
- Refer unresolved customer grievances to designated departments for further investigation
- Review insurance policy terms to determine whether a particular loss is covered by insurance
- Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
Technical Support Representative
Trilogy Fulfillment
09.2011 - 09.2013
- Calculate purchase subtotals, taxes, and shipping costs for submission to customers
- Correspond with online customers via electronic mail, telephone, or other electronic messaging to address questions or complaints about products, policies, or shipping methods
- Cancel orders based on customer requests or inventory or delivery problems
- Create or maintain database of customer accounts
- Create, manage, or automate orders or invoices, using order management or invoicing software
- Deliver e-mail confirmation of completed transactions and shipment
- Disclose merchant information and terms and policies of transactions in online or offline materials.
Education
Some college - Healthcare Administration
Colorado Christian University
Lakewood, CO 07.2021 - 08.2023
Skills
- Microsoft Office Suite
- Healthcare regulations
- Patient advocacy
- Data entry
- Case management
- Attention to detail
- Team collaboration
- Problem-solving
- Adaptability and flexibility
- Medical terminology
- Written and Oral Communication
- Computer literacy
- CRM software
- Time management
- Call Center Customer Service
- Phone communication
- Benefits verification
- HIPAA compliance
- Effective communication
- CRM system proficiency
- Salesforce Platform
Certification
- Certified Payroll Professional
- Driver's License
Timeline
Benefits Verification Specialist
MMC Group
10.2025 - Current
Customer Service Representative - Contractor
Chenega Professional & Technical Services
04.2025 - 07.2025
Case Manager
MMC Group Professional Staffing - Company Cencora
09.2024 - 03.2025
Customer Service Representative
Dawson/Spinlife
09.2023 - 11.2023
Recruitment Specialist
Manpower/Fedex Express
08.2022 - 07.2023
Some college - Healthcare Administration
Colorado Christian University
07.2021 - 08.2023
Medicaid Member Services Representative
Molina Healthcare
10.2020 - 10.2021
Customer Service Representative
Healthcare Support Staffing
06.2020 - 10.2020
Customer Care Representative II
Anthem Blue Cross Blue Shield
01.2019 - 12.2019
Transportation Driver
Uber
05.2017 - 06.2020
Customer Care Representative II
Anthem Blue Cross Blue Shield
02.2016 - 06.2018
Customer Service Representative
Kelly Services
11.2015 - 02.2016
Health Care Assistant
Private Home - Elderly Care
09.2014 - 11.2025
Technical Support Representative
Trilogy Fulfillment
09.2011 - 09.2013