Veneisha Ezzard
Lithonia,GA
Summary
Personable and dedicated Customer Service Representative with extensive experience in Healthcare Customer Service & general Customer Service industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
11
11
years of professional experience
Work History
Healthcare Customer Service Representative
Kaiser Permanente
Duluth, GA
09.2023 - Current
- The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patient and providers with accurate, consistent, timely and meaningful information•They will provide support to member's with an increased level of complexity in inquiries and issues as they utilize the KP plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines•Member Core :Facility Inquiry, Web Support, Promote KP.Org, Order ID Card, Complaint, ID Card Inquiry, Service Review•Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults•Medicare (For up to two (2) regions.)•Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General Reinstatement Request, Service Review•KPC Billing1095 Tax Form , SLP* (escalations to Tier 3)•Service Billing: Billing Inquiry, Make Payments, Complaints, Payment Plan, General, Service Review•Claims: Claim Inquiry, Claim Referral Inquiry, Complaint, General, Provider Demographic Update, Service Review•PSNAP: Post Stabilization Notification and Authorization Project•Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues•Responds professionally to inquiries from internal/external customers•Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed•Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery•Documents conversations with members according to procedure•Follows established procedures to meet customer/member needs•Required to effectively interact with diverse work units and relevant organizational departments•Ability to understand relevant policies, processes and customers•Assist the department in meeting customer needs and reaching department expectations•Completes required training and understand how to use tools available to recall necessary information•Develop a full awareness of the way performance and actions affect members and Member Service Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted)•Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service•Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintains the privacy and confidentiality of information, and protects the assets of the organization•Performs other relevant duties as required
Healthcare Customer Service Representative
Rose International, Kaiser Permanente
Duluth, Georgia
11.2022 - 09.2023
- The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patient and providers with accurate, consistent, timely and meaningful information•They will provide support to member's with an increased level of complexity in inquiries and issues as they utilize the KP plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines•Member Core :Facility Inquiry, Web Support, Promote KP.Org, Order ID Card, Complaint, ID Card Inquiry, Service Review•Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults•Medicare (For up to two (2) regions.)•Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General Reinstatement Request, Service Review•KPC Billing1095 Tax Form , SLP* (escalations to Tier 3)•Service Billing: Billing Inquiry, Make Payments, Complaints, Payment Plan, General, Service Review•Claims: Claim Inquiry, Claim Referral Inquiry, Complaint, General, Provider Demographic Update, Service Review•PSNAP: Post Stabilization Notification and Authorization Project•Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues•Responds professionally to inquiries from internal/external customers•Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed•Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery•Documents conversations with members according to procedure•Follows established procedures to meet customer/member needs•Required to effectively interact with diverse work units and relevant organizational departments•Ability to understand relevant policies, processes and customers•Assist the department in meeting customer needs and reaching department expectations•Completes required training and understand how to use tools available to recall necessary information•Develop a full awareness of the way performance and actions affect members and Member Service Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted)•Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service•Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintains the privacy and confidentiality of information, and protects the assets of the organization•Performs other relevant duties as required
CLAIMS ADJUSTER
State Farm
Duluth, GA
01.2022 - 08.2022
- Answered customer questions regarding deductibles.
- Prepared summaries of damage, payments and policy coverage.
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Negotiated Type settlement agreements to resolve disputes.
- Evaluated evidence with ultimate goal of creating positive outcomes for client's claims.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Investigated claims involving potential and suspected fraudulent activities.
- Answered questions posed by insured and attorneys.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Reported to management on customer problems, field conditions, safety issues and policy problems.
- Documented all investigation activity and presented reports to management.
- Maintained claims data in Type systems.
CUSTOMER SERVICE REPRESENTATIVE
Macy’s
Tucker, GA
09.2021 - 01.2022
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Responded to customer requests for products, services and company information.
- Assisted customers with setting appointments, special order requests, and arranging merchandise pick-up.
- Recommended products to customers, thoroughly explaining details.
- Provided primary customer support to internal and external customers.
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes.
- Cultivated customer loyalty, promoted repeat business and improved sales.
- Provided information regarding charge accounts and loyalty programs.
- Liaised with customers, management and sales team to better understand customer needs and recommend appropriate solutions.
- Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions.
Healthcare Patient Services Representative
DG Connections
Conyers, GA
07.2021 - 09.2021
- Compiled and reviewed medical charts.
- Explained plans for treatment and payment options.
- Used Software to schedule appointments.
- Educated patients on medicine and at-home healthcare tools.
- Reviewed daily care slips for doctors.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Followed document protocols to safeguard confidentiality of patient records.
- Facilitated communication between patients and various departments and staff.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Recommended service improvements to minimize recurring patient issues and complaints.
- Reviewed and corrected claim errors to facilitate smooth processing.
CASHIER
Walmart
Stone Mountain, GA
12.2020 - 07.2021
- Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
- Worked flexible schedule and extra shifts to meet business needs.
- Helped customers complete purchases, locate items and join reward programs.
- Restocked and organized merchandise in front lanes.
- Answered questions about store policies and addressed customer concerns.
- Promoted customer loyalty and consistent sales by delivering friendly service and knowledgeable assistance.
- Collected and authorized payments of guests.
- Worked closely with shift manager to solve problems and handle customer concerns.
- Maintained secure cash drawers, promptly resolving discrepancies in daily totals.
- Replenished sales floor merchandise and organized shelves, racks and bins for optimal appearance.
- Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies.
- Maintained cash drawer of $Amount or more per shift.
- Checked identification for proof-of-age for alcohol and tobacco sales.
- Mentored new team members on POS system operation, customer service strategies and sales goals.
- Completed inventory counts and ordered merchandise.
- Greeted over Number patients per day.
- Reviewed weekly sales ads and monitored price changes.
- Performed cash, card and check transactions to complete customer purchases.
- Operated cash register to record transactions accurately and efficiently.
- Maintained current knowledge of store promotions and highlighted sales to customers.
MAKEUP ARTIST - HAIRSTYLIST
Chyna’s Doll House Co.
Lithonia, GA
06.2019 - 12.2020
- Kept up-to-date with style industry standards, trends and techniques to provide optimal aesthetics services to every client.
- Conducted consultations to understand client's desired outcome and assessed skin type and face structure.
- Maintained full stock of inventory and properly sanitized makeup tools to avoid spread of infection.
- Applied makeup in accordance with clothing style.
- Professionally applied makeup to Number clients per month for outings, proms, weddings, funerals and other special occasions and events.
- Performed full makeup applications to Number clients per week.
- Provided clients with personalized skincare recommendations to support maintenance of healthy skin.
- Scheduled onsite and offsite makeup appointments for clientele.
- Employed variety of cosmetics to produce fresh looks, enhance facial features and manage skin tone.
- Conducted makeup classes for group of Number students.
- Built strong and lasting rapport with clients through consistent delivery of requested services and exceptional results.
- Answered phone calls and emails to schedule client appointments.
- Consistently received positive performance reviews from guests.
- Styled hair, makeup and nails for customers for special events and occasions.
- Educated clients about products and self-maintenance for healthy hair based on needs and preferences.
- Sanitized and organized station and tools by Action and Action.
- Maintained regular client list of up to Number repeat customers while handling Number walk-in clients daily.
- Kept detailed records of customer information and services provided to increase return customers by Number.
RECEPTIONIST
AEI StartUp Factory
Lithonia, GA
02.2019 - 06.2019
- Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments
- Greet persons entering establishment, determine nature and purpose of visit, and direct or escort them to specific destinations
- Transmit information or documents to customers, using computer, mail, or facsimile machine
- Hear and resolve complaints from customers or the public
- Perform administrative support tasks, such as proofreading, transcribing handwritten information, or operating calculators or computers to work with pay records, invoices, balance sheets, or other documents
- File and maintain records
- Provide information about establishment, such as location of departments or offices, employees within the organization, or services provided
- Collect, sort, distribute, or prepare mail, messages, or courier deliveries
- Process and prepare memos, correspondence, travel vouchers, or other documents
- Receive payment and record receipts for services
- Schedule appointments and maintain and update appointment calendars
- Analyze data to determine answers to questions from customers or members of the public
- Keep a current record of staff members' whereabouts and availability
- Enroll individuals to participate in programs and notify them of their acceptance
- Schedule space or equipment for special programs and prepare lists of participants
- Perform duties, such as taking care of plants or straightening magazines to maintain lobby or reception area
- Conduct tours or deliver talks describing features of public facilities, such as a historic site or national park.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
HELP DESK SUPPORT SPECIALIST
Robert Half Technical Staffing
Atlanta, GA
03.2017 - 03.2018
- Technical troubleshooting
- Assist customers w/ their technical issues
- Phone & online support
- Problem diagnosis
- Preventative maintenance
- User training support
- Complaint handling
- Customer service
CUSTOMER SERVICE REPRESENTATIVE
Concentrix Co
Norcross, GA
04.2015 - 03.2017
- 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
- Determine charges for services requested, collect deposits or payments, or arrange for billing
- 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
- Resolve customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills
- Obtain and examine all relevant information to assess validity of complaints and to determine possible causes, such as extreme weather conditions that could increase utility bills
- Complete contract forms, prepare change of address records, or issue service discontinuance orders, using computers
- Solicit sales of new or additional services or products
- Recommend improvements in products, packaging, shipping, service, or billing methods and procedures to prevent future problems
- Review claims adjustments with dealers, examining parts claimed to be defective, and approving or disapproving dealers' claims
- Order tests that could determine the causes of product malfunctions.
SERVICE DESK ASSOCIATE
Macy's
Lithonia, GA
11.2013 - 04.2015
- I was responsible for providing a great customer experience during customers shopping trip
- I assisted customers with online purchases/pickup, in store transactions, ringing and processing return merchandise, handling non-congruent items and performing other assigned duties in accordance with store rules, regulations & guidelines
- Determine customer needs based on personal features and other customer preference related factors
- Demonstrate knowledge of store products and services to build sales and minimize returns
- Suggest additional merchandise to compliment customer selection
Education
Diploma - Cosmetology Business
GEORGIA CAREER INSTITUTE
01.2015
High School Diploma -
MORGAN COUNTY HIGH SCHOOL
Skills
- Business Administration
- Computer systems operation
- Typing 60wpm, Basic
- Windows programs
- Microsoft Programs, Excel
- Individual Growth
- Customer Retention
- Liability Determinations
- Handling Denied Claims
- Customer Care
- Property Adjusting
- Service Quality
- Customer Feedback
- Administrative Support
- Customer Relations
- Customer Service Process Improvement
- Customer Satisfaction
- Insurance Verification
- Stress Tolerance
- Medical terminology knowledge
- Healthcare industry understanding
- Problem-Solving
- HIPAA Compliance
- Customer Service
- Eligibility Determination
- Money Handling
- Information Collection
- Payment Processing
- Medical Terminology
- Fee Collection
- Phone and Email Etiquette
- De-Escalation Techniques
- Call Documentation
- Customer Account Management
- Issue and Complaint Resolution
- Office equipment proficiency
- Teamwork and Collaboration
- Microsoft Office expertise
- Computer Skills
- Understanding Customer Needs
- Microsoft Office
- Attention to Detail
- Remote Office Availability
- Policies and Procedures Adherence
- Multi-Line Phone Systems
- Administrative and Office Support
- Customer Data Confidentiality
- Billing Adjustments and Refunds
- Excellent Communication
Timeline
Healthcare Customer Service Representative
Kaiser Permanente
09.2023 - Current
Healthcare Customer Service Representative
Rose International, Kaiser Permanente
11.2022 - 09.2023
CLAIMS ADJUSTER
State Farm
01.2022 - 08.2022
CUSTOMER SERVICE REPRESENTATIVE
Macy’s
09.2021 - 01.2022
Healthcare Patient Services Representative
DG Connections
07.2021 - 09.2021
CASHIER
Walmart
12.2020 - 07.2021
MAKEUP ARTIST - HAIRSTYLIST
Chyna’s Doll House Co.
06.2019 - 12.2020
RECEPTIONIST
AEI StartUp Factory
02.2019 - 06.2019
HELP DESK SUPPORT SPECIALIST
Robert Half Technical Staffing
03.2017 - 03.2018
CUSTOMER SERVICE REPRESENTATIVE
Concentrix Co
04.2015 - 03.2017
SERVICE DESK ASSOCIATE
Macy's
11.2013 - 04.2015
Diploma - Cosmetology Business
GEORGIA CAREER INSTITUTE
High School Diploma -
MORGAN COUNTY HIGH SCHOOL
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