Customer Service Quality Assurance
Resume:
S hatuan Harden
S *******@*****.***
Snellville GA, 30078
C areer Overview -
Recent college graduate in Business Administration with an
e mphasis in healthcare administration. Obtain a position as a team-player in a people-
oriented organization where I can maximize my Customer-Service experience in a challenging
environment to achieve the corporate goals.
Core Strengths-
Data Entry, Administrative Functions, Microsoft Officer, Excel, Power Point
Work Experiences
United Healthcare Insurance/Customer Service/Claims Representative
March 2011 to November 2012
West Corporation-Huntsville, AL
Inbound calls from 50 to 100 daily
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Benefit and Eligibility information.
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Billing and Payment issues.
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Customer material requests
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Physician assignment.
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Authorization for treatment.
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Responsible for the accurate processing and completion of medical claims.
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Process claims, that route out of automatic adjudication, within current turnaround
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standards.
Proficiency in product lines applicable to processing unit.
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Ability to understand and apply plan concepts to include:
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Explanation of Benefits (EOB)
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Deductible.
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Coinsurance.
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Co-pay.
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Out-of-pocket.
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Maximums, inside limits and exclusions State variations.
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Optum Rx/Pharmacy Mail order/Customer Service Representative
December 2011 to 2012
West Corporation- Huntsville, AL --
Inbound calls from 50 to 100 calls daily
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Verify customer and order information for correctness, checking it against previously
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obtained information as necessary.
Obtain customers' names, addresses, and billing information, product numbers, and
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specifications of items to be purchased, and enter this information on order forms.
Send and received prescription orders and fax Doctor's office.
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Inform customers by mail or telephone of order information, such as unit prices, shipping
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dates, and any anticipated delays.
Receive and respond to customer complaints.
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File copies of orders received, or post orders on records.
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Prepare invoices, shipping documents, and contracts.
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Review orders for completeness according to reporting procedures and forward
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incomplete orders for further processing.
Direct specified departments or units to prepare and ship orders to designated locations.
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Compute total charges for merchandise or services and shipping charges.
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Confer with production, sales, shipping, warehouse, or common carrier personnel in order
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to expedite or trace shipments.
Check inventory records to determine availability of requested merchandise.
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Recommend merchandise or services that will meet customers' needs.
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Attempt to sell additional merchandise or services to prospective or current customers by
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telephone or through visits.
Notify departments when supplies of specific items are low, or when orders would
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deplete available supplies.
Calculate and compile order-related statistics, and prepare reports for management.
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Collect payment for merchandise, record transactions, and send items such as checks or
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money orders for further processing.
Inspect outgoing work for compliance with customers' specifications.
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Recommend type of packing or labeling needed on order.
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Adjust inventory records to reflect product movement
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General Clerk
June 1999 to 2007
Great Lakes Photography- Great Lakes, IL
Coordinated a schedule for 36 staff member and 1056 clients weekly.
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Maintained logs, files and records for customer purchases and product shipments to
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vendors.
Performed general clerical duties to include but not limited to answering phones, talking
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messages, photo copying, faxing and processing all incoming and outgoing mail.
Completed project assignment ahead of schedule, exceeding quality assurance standards
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Requisitioned officer furniture and supplies.
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Diplomatically resolved customer’s complaints as needed bases.
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Cashier
January 1993 to 1996
JC Penney Vernon Hills, IL
• Answered customer’s questions and providing information on procedures and
p olicies.
• Computer and record of transactions.
• Issued receipts, refunds, store credit, and change to the customer.
• Resolved customer complaints.
• Request information using paging systems.
• Created shipment dates of when products will be delivered.
• Conducted layaways.
• Kept periodic balance sheets of amounts and numbers of transactions.
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Education Background
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American Intercontinental University, June, 2009 to 2010
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Hoffman Estates, IL
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Business Administration/Healthcare Management
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Associates Degree
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Ashford University Online, November 2011 to 2013
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400 North Bluff Boulevard, Clinton, IA 52732
Early Childhood Education
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Bachelor’s degree
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North Chicago High School, 1994 to1997
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Chicago, IL
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Business
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Diploma
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Fitness Instructor- Certified Zumba Instructor
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References up request
Contact this candidate