Customer Service Sales
Resume:
Shannon Ellis
*** ******* **, ****** ** *****
************@*****.***
qualifications
Service/Support Professional
Possess the talent for identifying customer needs and presenting appropriate company product
and service offerings. Possess excellent interpersonal skills in conjunction with outstanding
client relationships and exceptional communication skills with the ability to communicate
information effectively. Expertise in resolving escalated service issues. Secured numerous
company achievement awards for delivery of exceptional customer service. Proficient with
Microsoft Office System (including Microsoft Word, Microsoft Excel, Microsoft PowerPoint ,
Microsoft Access, and Microsoft Outlook ).
education, professional registration
Bernie L. Edmondson High School East Orange, New Jersey
Public Health Major Diploma Received 06/1999
PROFESSIONAL EXPERIENCE
06/13-current Quadel Consulting- Eligibility Analyst
Newark, NJ
Resolve application discrepancies between FEMA Database and Renewjerseystronger.org
Database info received.
Collect/Review all pertinent documentation supporting Damage Loss, verification of
expenses, property ownership, funds
previously received via Homeowner's insurance and SBA loans
Verify that Damage Property Address was the applicant's primary residence at the
time of Hurricane Sandy via phone
and documentation received.
Assist with Quality Control review of all employees' assignments
Partake in all special projects that arise including mailing, duplication of
application reviews, A/R-A/C, extensive data entry
Submit all finalized applications for Grant awards after confirming that all State
and HUD guidelines were met
12/11-04/2013 Apollo Health Street-Process Monitor
Clifton, NJ
Review Horizon plan info and load policy/benefit into CPL database
Confirm that all info was received from Horizon's sales team to document and load
all required information efficiently
Audit Horizon benefit info housed in PIBA system to confirm that all information is
correct and thoroughly
and document all errors found. Maintain detailed records/notes and forward to sales
team for correction
10/09- 04/11 Aerotek/HBCBSNJ - Managed Care Coordinator
Newark, NJ
Perform review of service requests for completeness of information, collection and
transfer of non-clinical data, and acquisition of structured clinical data from
physicians/patients for pre-existing conditions review for both Managed Care and
Traditional Policies.
Review and apply Medical Policy guidelines and mandates to efficiently process
multiple claim edits that arise and follow prompt payment regulations. This task
includes processing claims correctly according to authorization info, pre-existing
condition determinations, and administrative approvals.
Initiate call backs and correspondence to members and providers to coordinate and
clarify benefits and claim status information. This task includes generating
Pre-existing conditions denial letters to members, and generating additional
information requests to Providers.
11/08-09/09 Magellan Health Services- Customer Service Rep
Parsippany, NJ
Research and articulately communicates information regarding member eligibility,
benefits, EAP services, claim status, and authorization inquiries to callers while
maintaining confidentiality
Administration of intake documentation in the appropriate systems
Link/ make routine referrals and triage decisions not requiring clinical judgment
Provide information regarding Magellan's in-network and out of network
reimbursement rates and states multiple networks to providers
Identify and respond to Crisis calls and continues assistance with the Clinician
until the call has been resolved
Educates providers on how to submit claims and when/where to submit a treatment
plan
Provide outstanding service to our internal and external customers and strive to
resolve member and provider needs on the first contact
Provide outstanding service while also achieving operating performance rating of
meets or exceeds production standards
05/06-10/08 Axa Equitable- Financial Services Rep
Secaucus, NJ
Troubleshooting/processing/resolving client, broker, agent's inquiries via email,
phone, mail
Process Credit/Debit card payments and debits according to all Nasdaq rules and
guidelines
Process trades as requested via brokers/clients/agents in regards to annuities and
mutual funds
Send/Receive additional payments via EDI systems
Educate brokers/clients/agents on products offered and upcoming updates to policy
information
Contact this candidate