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Customer Care Specialist Resume

Philadelphia, PA

PROFESSIONAL SUMMARY:

  • Results - oriented Customer Care Specialist in management and customer service.
  • Dedicated to providing excellent customer service and making operational and procedural improvements.

SKILLS OBTAINED:

  • Knowledge of billing, coding, Office management, typing 45-50 wpm
  • CPR certified

SKILL HIGHLIGHTS:

  • Client relations specialist Focused on customer satisfaction
  • Meticulous attention to detail Deadline-oriented
  • Skilled multi-tasker Client relations specialist

PROFESSIONAL EXPERIENCE:

Confidential, Philadelphia, PA

Customer Care Specialist

Responsibilities:

  • Developed, implemented and monitored programs to maximize customer satisfaction.
  • Improved service quality by developing a strong knowledge of company's products and services.
  • Addressed negative customer feedback immediately.
  • Provided detailed monthly departmental reports and updates to senior management.
  • Effectively communicated with team members to maintain clearly defined expectations.
  • Performing hardware and software support in the Customer Support Center for Confidential employees.
  • Effectively managed departmental expenses to stay within allocated budget.
  • Troubleshooting desktop operating systems, desktop software, hardware issues and installing LAN printers

Confidential, Philadelphia, PA

Business Specialist

Responsibilities:

  • Routinely prepared and evaluated CRM reports to identify problems and areas for improvement.
  • Recommended changes to existing methods to increase the accuracy, efficiency and responsiveness of the customer service department.
  • Lead on and off-site customer support teams across multiple time zones.
  • Responsible for triaging issues to correct area to assist and resolve for customers including internal and external.
  • Complete Clean up on various claims suspend issues that cannot be resolved by claims analyst/adjusters.
  • Identify root cause analysis and ensure claims are seen through to finalization.

Confidential, Philadelphia, PA

Provider Appeals Specialist

Responsibilities:

  • Verified and logged in deadlines for responding to daily inquiries.
  • Maintained detailed administrative and procedural processes to improve accuracy and efficiency.
  • Contacted providers to discuss status of rebilling and reimbursement process to ensure account resolution.
  • Contacted insurance providers to verify correct insurance information and get authorization for proper billing codes.
  • Successfully established effective systems for record retention by creating database for daily correspondence tracking.

Confidential, Philadelphia, PA

Claims Adjuster

Responsibilities:

  • Review claims to ensure processes correctly
  • Research claims for duplicate payment
  • Worked multiple projects where several claims were impacted to ensure proper payment
  • Assisted with distribution of work.
  • Adjusted claims.

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