Whitney Brown
Society Hill,SC
Summary
Dedicated Customer Service Representative motivated to maintain customer satisfaction and contribute to company success. Proven ability to establish rapport with clients and exceed company expectations. Reliable and driven, with strong time management and prioritization abilities. Customer Service Agent who is looking to pursue a professional career that allows the opportunity for advancement, to utilize and strengthen the skills that enable me to positively impact the company's growth. Able to multi-task is commendable, along with a very good sense of how to adapt to new surroundings. Understanding the importance of putting a client needs into consideration first highly motivated experienced working in a fast-paced environment.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
BLUE CROSS BLUE SHIELD
10.2020 - Current
- Identify incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines
- Examines and processes claims and/or nonmedical appeals according to business/contract regulations, internal standards and examining guidelines
- Enters claims into the claim system after verication of correct coding of procedures and diagnosis codes
- Ensures claims are processing according to established quality and production standards
- Responsible for responding to customer inquiries
- Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures
- Performs research as needed to resolve inquiries
- Reviews and adjudicates claims and/or nonmedical appeals
- Determines whether to return, deny or pay claims following organizational policies and procedures.
Customer Service Representative/ Technical Support
SYKES ENTERPRISES
07.2017 - 10.2019
- Performed identity verication for each caller to determine if the individual was authorized to perform requested service (promotion to the administrator, credit card entitlements, authorization to view sensitive nancial data
- Worked closely with Supervisors/Managers to ensure expedited customer service for all rst data merchants
- Asked eective questions and gathers information to determine the source of problems and customer needs
- Following up and escalate on service and supply requests on an ongoing basis
- Document maintenance of information in all logs and reports with a keen attention to detail
- Answered inbound call as well as assist customers who have specic inquiries
- Responsible for providing customer service and solutions through telephone, online chat, and email.
Customer Service Representative
MEDCOST
02.2015 - 07.2017
- Provide service and resolution when applicable at the levels dened for customer service representatives
- Log each inquiry into the call tracking system and document the call type, referral code and all narrative documentation to support the call
- If necessary, determine the need for resolution within the appropriate referral channels and send request for additional action steps
- Make necessary outbound calls to correct issues or facilitate resolution for customer
- Stay abreast of resource information to ensure appropriate information is being provided
- Coordinate resolution of open issues from incoming inquiries assigned either through management of open issues log, or through call backs requested from voice mail
- The capability to service & train others on incoming email/web referrals, and our web chat platform
- Explains the program and advises patients of methods to become eligible by rearranging nances and assets.
Education
High School Diploma -
Marlboro County High School
Bennettsville, SC05.2010
Skills
- Time-management
- Organization
- Communication
- Problem Identification and Resolution
- Administrative Support
- Patience/Empathy
- Problem-solving skills
- Critical thinking skills
Accomplishments
Client Satisfaction - Received positive feedback from clients or customers while working remotely.
Personal Information
Title: Customer Service Representative
Timeline
Customer Service Representative
BLUE CROSS BLUE SHIELD
10.2020 - Current
Customer Service Representative/ Technical Support
SYKES ENTERPRISES
07.2017 - 10.2019
Customer Service Representative
MEDCOST
02.2015 - 07.2017
High School Diploma -
Marlboro County High School
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