Torina Williams-Zeigler
Saint Petersburg,FL
Summary
More than 10 years of cash handling experience in an office setting. Handling customers and associates complaints. Experienced in operations of training, passionate about quality and customer satisfaction. Excellent interpersonal skills, quick learner. Willing to do whatever it takes to get the job done. Effective leadership skills and the ability to motivate others. Excellent oral, written and communication skills. Presentation skills are a plus. Currently working in the field of Healthcare, Medicaid & Medicare transportation, & FWA/SIU Dept.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Fraud Specialist
Fraud Waste & Abuse-SIU
08.2015 - Current
- Responsible for processing appeals and audits before deadline
- Respond to provider's emails and voicemails in a timely manner
- Assist providers with issues they may have regarding their audits
- Investigate trips to make sure members are being taken to their appointments
- Verify drivers and vehicles are credentialed
- Assisted inbound callers with transportation to and from medical appointments
- Verified Medicare/Medicaid eligibility through outbound calls to insurance providers
- Faxed needed forms to clients and providers to ensure correct level of needs for transport
- Verified medical appointments with physicians' offices to confirm critical care for patients needing transport
- Responsible for taking calls from member and providing them with excellent customer service, scheduling transportation for members
- Credentialing department- Responsible for auditing drivers, data entry and ensuring that all drivers are state regulated to provide services to Medicaid and Medicare clients
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Improved customer trust by promptly addressing and resolving reported instances of fraud.
- Conducted thorough investigations into suspected fraudulent activities, resulting in timely resolution of cases.
- Reduced instances of fraud by implementing comprehensive detection and prevention strategies.
- Maintained detailed records of all detected fraud incidents for future reference and analysis.
- Conducted regular audits of fraud controls, ensuring compliance with regulatory standards and identifying areas for improvement.
Customer Service Rep
Access2 Care
01.2012 - Current
- Assisted inbound callers with transportation to and from medical appointments
- Verified Medicare/Medicaid eligibility through outbound calls to insurance providers
- Faxed needed forms to clients and providers to ensure correct level of needs for transport
- Verified medical appointments with physicians' offices to confirm critical care for patients needing transport
- Responsible for taking calls from member and providing them with excellent customer service, scheduling transportation for members
- Enhanced customer satisfaction by promptly addressing concerns
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Collaborated with team members to develop best practices for consistent customer service delivery
Customer Service Staff
Publix Supermarket
01.2006 - 01.2010
- Responsible for opening and closing cash office, training for office staff, and cashier training/ Training for management and leadership position, and multi-trained throughout the store in all different departments
- Responsible for writing off bad or returned checks to the State Attorney's office
- Maintained the ordering of office and store supplies
- Keep record of customers interactions or transactions, recorded details and inquires, complaints or comments as well as actions taken to resolve any problems or concerns
- Process merchandise returns or exchanges
- Receive payment by cash, check, credit cards, gift certificates or automatic debits
Customer Service Representative
All State Insurance
01.2004 - 01.2008
- Responsible for rescheduling appointments and ensuring accuracy on insurance policies
- Sent out correspondence regarding updates on policies terms
- Determine charges for services requested, collect deposits or payment, or arrange for billing
- Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
Front End Lead
Kmart
01.2002 - 01.2004
- Responsible for making schedules, running front-end cashiers, ensuring customer satisfaction
- Ensured accuracy in the Customer Service Department
- Reduced overtime by 73% and workforce by 15% while increasing productivity by 10%
- Resolved customer complaints or answered customers' questions regarding return policies
- Discuss job performance problems with employees to identify causes and issues and to work on resolving problems
Customer Service
Van Ru Credit Corp
01.1998 - 01.2002
- Arrange for debt repayment or establish repayment schedules, based on customers' financial situations
- Locate and notify customers of delinquent accounts by mail or via telephone
- Answer customer questions regarding problems with their accounts
- Record information about financial status of customers and status of collection efforts
- Process payments that were received via mail and post to the correct accounts
- Sent updates via email to all 3 major credit reporting agencies
Education
CERTIFICATE - Human Services
SAINT PETERSBURG COLLEGE
Saint Petersburg, FL12.2017
Associate of Arts - Human Services
SPCollege
St. Petersburg, FL12-2015
AA Degree - Social Worker
SAINT PETERSBURG COLLEGE
Saint Petersburg, FL05-2014
Training - HHA 75hrs Completion, Blood Borne Pathogens, HIV/AIDS Prevention, CPR, Admin in Medication, Infection Control Training, Alzheimer's training
AMERICUS MEDICAL ACADEMY
Saint Petersburg, FL01.2010
CDA Certificate -
SAINT PETERSBURG TECHNICAL CENTER
Saint Petersburg, FL01.1995
Skills
- Diverse computer experience
- Complaint Handling & Resolution
- Adapting new procedure
- Customer Satisfaction
- Microsoft Word
- Microsoft Excel
- Money Handling experience
- Applying information tasks
- Multitasked
- Attention to detail
- Anti-fraud systems
- Transaction monitoring
- Internal controls
- Investigation techniques
- Verbal and written communication
- Telephone and email etiquette
- Fraud detection
- Case management
Accomplishments
- Collaborated with team of [6] in the development of VSS Department.
Certification
- Certified Nursing Assistant (CNA)
- Certified Medical Assistant (CMA)
- First Aid Certification
- Basic Life Support Certification (BLS)
- Fla Driver's License
- CPR/AED Certification
- Home Health Aide (HHA) Certification
- OSHA Certified
- Salesforce Certified Administrator
Languages
English
Full Professional
Timeline
Fraud Specialist
Fraud Waste & Abuse-SIU
08.2015 - Current
Customer Service Rep
Access2 Care
01.2012 - Current
Customer Service Staff
Publix Supermarket
01.2006 - 01.2010
Customer Service Representative
All State Insurance
01.2004 - 01.2008
Front End Lead
Kmart
01.2002 - 01.2004
Customer Service
Van Ru Credit Corp
01.1998 - 01.2002
Training - HHA 75hrs Completion, Blood Borne Pathogens, HIV/AIDS Prevention, CPR, Admin in Medication, Infection Control Training, Alzheimer's training
AMERICUS MEDICAL ACADEMY
CDA Certificate -
SAINT PETERSBURG TECHNICAL CENTER
- Certified Nursing Assistant (CNA)
- Certified Medical Assistant (CMA)
- First Aid Certification
- Basic Life Support Certification (BLS)
- Fla Driver's License
- CPR/AED Certification
- Home Health Aide (HHA) Certification
- OSHA Certified
- Salesforce Certified Administrator
CERTIFICATE - Human Services
SAINT PETERSBURG COLLEGE
Associate of Arts - Human Services
SPCollege
AA Degree - Social Worker
SAINT PETERSBURG COLLEGE
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