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Customer Service Representative/Claims Analyst

Location:
San Antonio, TX
Salary:
16.00
Posted:
July 27, 2015

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Resume:

Michelle Moya

***** ****** ** *** ***

San Antonio, Texas 78216

Cell 210-***-****

acqx95@r.postjobfree.com

Summary

Progressive business and customer service professional with 22 plus years of diversified business and customer service experience. Highly motivated, energetic, persevering, with a reputation as a results oriented contributor with the ability to balance organizational priorities, with those of the customer, the team, and other stakeholders

Professional experience

Member Services Claim Analyst

Community First Health Plans, San Antonio, Texas July 2008 - May 2015

Served as a liaison to members and providers in resolving member service issues. Provided information to members and providers regarding eligibility and billing information. Assisted providers with denied claims and ensured compliance with the Health Insurance portability and accountability act (HIPPA) related policies to all in regards to all aspects of operations within the member services department.

Customer Service Representative

Pocket Communications, San Antonio, Texas July 2006 - July 2008

Responsible for handling incoming and outbound interactions with customers regarding their cellular phone accounts. Processed customer transactions, which included obtaining, entering and verifying customer information, answering questions, resolving phone issues, exchanges, returns and attempting to sell products or make up sells as necessary.

Tracking Agent

RMH UPS, San Antonio, Texas January 2003 - July 2006

Responsible for checking shipping information, account verification, problem resolution, and credit refunds. Also handled customer callbacks and escalations as needed.

Collections Manager

Emerson Bail Bond, San Antonio, Texas July 2001 - January-2003

Responsible for daily audits, payment verification, account reconciliation, and data entry. Additional duties included fingerprinting.

Customer Care Supervisor/Quality Assurance

Harland Checks, Corpus Christi, Texas July 1993 – July 2001

Responsible developing and supporting Customer Service Representatives to ensure that all established quality and service goals are attained. The Supervisor will work closely with the Call Center Managers and Director, other supervisors, and other Centers as well as field sales and Plants to ensure that overall Center goals are attained and that the maximum productivity of each Customer Service Representative is achieved.

Additional Skills: Bilingual Fluent in Both English and Spanish.

Education

Edgewood High School

San Antonio, Texas 1989

Southern Careers Pharmacy Technician 2005-2006

References

References made available upon request.



Contact this candidate