Customer Service Insurance

Donna Hamilton Smith

*** ***** **** *** - *******, GA 30228

**********@*****.*** - 678-***-****

Diverse experience across People Management, Customer Support, Training, Quality and Compliance and

Inbound Call Center Operations. Proven talent in identifying needs, recommending effective solutions, and gaining

commitment for results. Team-oriented approach with the ability to gain cooperation from different areas and

levels within the organization:interact with corporate executives in decision-making processes.

WORK EXPERIENCE

Vendor Manager

PPMS South, Inc. - Atlanta, GA - August 2012 to April 2013

Managed and assigned property preservation and inspection jobs to contractors. Also insured the job was

completed in accordance of HUD/government standards through use of UPAMS computer system. Responsible

to maintain superb communication between contractor and client.

Customer Service Representative II

ACS, Inc. - Nashville, TN - August 2009 to August 2012

Assisted Medicare and/or Medicaid recipients with State of Tennessee in filing appeals for service rejections.

Trained new associates the expectations and process of job role. Responsible for resolving issues and escalations

regarding service failures.

Licensed Health Agent

NationsHealth - City of Sunrise, FL - July 2008 to August 2009

Assisted eligible Medicare recipients with enrollment through their eligible state Medicare plan. Contacted

providers to confirm participation in the Medicare private fee for service plan. Also assisted existing members with

account information changes, updates in insurance coverage regarding Cigna members plan.

Supervisor

Aetna Specialty Pharmacy - Orlando, FL - February 2005 to October 2006

Ensured call center service measures met or exceeded contracted goals:75%TSF, 30 sec ASA, and 4%

abandonment rate. Motivated departmental teams for continued associate engagement to increase overall

productivity. Responsible for staffing call center and maintaining operational measures.

Admissions Coordinator

Curascript Pharmacy - Orlando, FL - May 2002 to January 2005

Duties included coordinating benefits for insureds by effectively communicating with insurance companies for

proper verification of insurance coverage, check eligibility for patients / insured current effectiveness, responsible

for re-authorization of ongoing pharmaceutical care of patients by contacting medical doctor's office, processed

test claims online by inputting medication, proper dosage, and quantity to get copay information. In addition,

coordinated home visits for new patients on proper administration of medications.

Insurance Rater

CNA Insurance - Orlando, FL - October 1998 to April 2002

Provided world-class customer service with timely and accurate information to agency personnel,underwriters,

and account executives. Duties also included providing and rating new and renewal quotes. In addition, processed

policy endorsements on all lines of commercial business including Automobile, Workers Compensation, General

Liability, Property, Crime and Inland Marine. Requested missing information,motor vehicle reports and collected

exposure and rating data in order to effectively complete quotes or policy issuance.

Member Services Counselor

American Automobile Association - Heathrow, FL - May 1995 to August 1996

Responsibilities included answering member calls requesting road service and credit card registration on a

nationwide basis. Also obtained detailed information from members and inputting into system, assisted members

with travel directions and selling AAA memberships. Also coded calls properly and completed special assignments.

EDUCATION

Certificate in Travel Industry

International Aviation and Travel Academy - Arlington, TX

1989 to 1990

Draughons College - Nashville, TN

1987 to 1989

Diploma

Overton High School - Nashville, TN

1984 to 1987

ADDITIONAL INFORMATION

Call Center Operations (Staffing, IVR, Genysis- Skill Routing, Adherence, Avaya), People Soft Trainer, People

Management Proficient: Microsoft Word, Microsoft Excel, Medical Terminology, ICD-9, CPT codes and the

Physicians Desk Reference (PDR) Typing (50 wpm), 10-key (by touch), accounting programs and spreadsheets

Specialty Pharmacy

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