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Customer Service Representative Ii Resume

Hunt Valley, MD

SUMMARY

Dedicated Customer Service Representative who provides exceptional customer service through active listening and problem solving.Call Center Representative with expertise providing customer support in high call volume environments. Exceptional computer aptitude and telephone etiquette.

TECHNICAL SKILLS

  • Customer Service Representative
  • CMS - MEDICARE BENFICIARY DATA BASE SUITE
  • Confidential
  • HPMS
  • Confidential Facets
  • Confidential
  • Infrocrossing
  • Filenet

PROFESSIONAL EXPERIENCE

Customer Service Representative II

Confidential, Hunt Valley, MD

Responsibilities:

  • Respond to and resolve members questions regarding Benefits, Eligibility, Claims and Health Savings Account.
  • Assist and Educate members about the fundamentals of Health Spending Accounts Assist members in navigating the member portal and company website Provide status on previous submitted claims
  • Assisting Members with basic understanding of what benefits that was given to them by their Employers. Skills Used
  • Attentive Listening Skills First Call Resolution Skills Handling Irrate Member Skills

Customer Service Rep II

Confidential

Responsibilities:

  • Provide services to Providers and Members regarding health benefits, pharmacy and plan information Assist with verifying and explaining benefits and coverage associated with different health plans Describe exclusions and non - covered treatments associated with the plan Verified and provided claim information to Provider
  • Addressed and resolved customer product complaints empathetically and professionally Accurately documented, researched and resolved customer service issues.
  • Referred unresolved customer grievances to designated departments for further investigation?
  • Managed high call volume with tact and professionalism.
  • Acted professionally and patiently when addressing negative customer feedback.
  • Met or exceeded service and quality standards every review period.

Administrator

Confidential

Responsibilities:
  • Right Hand Admin/ ST Agnes Hospital-Levingdale Lab - 2411 Belvedere Ave
  • Input ICD9 coding into system for patient billing
  • Separated and distribute lab requisitions to doctors
  • Fax requisitions to doctors as ordered
  • Verified the four day window for payments
  • Verified correct test are provided for patients
  • Handle incoming calls regarding to lab work performed

Customer Service Rep II

Confidential

Responsibilities:
  • Verified beneficiary claim status and eligibility
  • Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.
  • Answered a constant flow of customer calls with up to 30+calls in queue per minute
  • Assist with explaining beneficiaries health plan and formulary information regarding Medicare Part D
  • Meet beneficiaries individual health care needs
  • Locate and interpret complex information from multiple applications and 2 monitor system Addressed and resolved beneficiaries complaints empathetically and professionally Accurately documented, researched and resolved customer service issues Referred unresolved customer grievances to designated departments for further investigation

Customer Service Rep II

Confidential

Responsibilities:

  • Processed claims, Identified. Researched, analyze and resolved any questions regarding MEDICARE Assist with questions regarding monthly invoices, low income subsidy, formulary and premiums coverage Enter claims into database while following policies and procedures Gathered and verified all required customer information for tracking purposes.
  • Resolved inquires using Confidential, Confidential, FACETS AND CCRX NET WEBSITE Addressed and resolved customer product complaints empathetically and professionally.
  • Referred unresolved customer grievances to designated departments for further investigation.
  • Met or exceeded service and quality standards every review period

Customer Care Specialist

Confidential

Responsibilities:

  • Defused volatile customer situations calmly and courteously.
  • Accurately documented, researched and resolved customer service issues
  • Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment
  • Managed high call volume with tact and professionalism
  • Met or exceeded service and quality standards every review period

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