Customer Service Representative

Consuelo Prowell

*** **** **** ***** ********, FL

***** ****: 407-***-**** Home: 321-***-****

************@*****.***

OBJECTIVE: Seeking a position that will benefit from my customer service experience and where

my expertise can improve customer satisfaction.

SUMMARY OF QUALIFICATIONS:

• Ability to speak with patients to convey information effectively.

• Capable of using logic and reasoning skills to identify and solve customer issues and

complaints.

• Knowledgeable of all Microsoft applications, Infosys, ShoreTel, and Great Plains programs.

• Analyzing information and evaluating results to obtain a favorable outcome.

WORK EXPERIENCE:

Alere Home Monitoring 03/2010-present Orlando, FL

Benefit Coordinator

• Handle customer inquiries, complaints, billing, and payment service requests.

• Explain financial breakdown of patient responsibilities as determined by the health plan.

• Verify patient information and schedule delivery of medical supplies via UPS.

• Collect payments for medical supplies by credit card or check by phone.

• Create supply orders for patients to continue home testing.

• Identify and evaluate opportunities to retain customers in accordance to company policy.

• Answer 40-60 daily inbound and outbound calls.

Customer Care Representative 9-2008 to 3/2010

• Handled inbound \outbound calls for existing business via telephone and e-mail using the

“3-key point” format

• Used product and clinical knowledge to overcome technical and business objections from

p rospective customers

• Accurately entered patient information in proper databases

• Possessed full knowledge of products offered by the company

• Handled all daily procedures for product and AOB fulfillment for both patients and

customers

• Processed all customer orders from website and provided t racking information

• Coordinated orders with insurance department and communicate results to patients

• Followed all regulatory policies and procedures; privacy and security standards in

accordance with government agencies and H IPPA requirements

• Average 80-100 inbound and outbound calls daily.

January 2004 to August 2008 I suffered from severe health complications rendering my ability to seek

employment.

CNA Group Disability and Life 8/01-01/04 Orlando, FL

Customer Service Representative

• Headed customer relations for various clients looking to file insurance for short and long term

disability.

• Maintained over 500 employer based groups nationwide for accurate employee information.

• Informed claimants about payment information and status of claims

• Advised claimants and employers of policy and procedures based on insurance criteria.

• Achieved number goal which is to “resolve issues within one call and not to transfer to a

Agent or Disability Specialist.”

United Health Care 12/00-07/01 Orlando, FL

Customer Service Representative

• Assist clients with medical insurance claims questions regarding their current policy, billing,

co-pays, explanation of benefits, and ICD-9 codes.

• Acted as liaison between clients and healthcare providers to ensure clients receive adequate

care based on policy criteria.

• Initiated pre-authorizations for clients when medically necessary.

ACHIVEMENTS:

• Awarded Certificate of Recognition for superb customer service and quality control.

• Received 23 customer appreciation letters for outstanding services.

E MPLOYEE DEVELOPMENT:

• 9 Traits of H ighly Successful Teams, January 2009

• The Super Productivity Conference, Fred Pryor Seminar, February 2009

• Cultural Background, Abuse and Neglect, Supplier Standards, Code of Ethics, Conflict of

I nterest, Advanced Directive, Mission Statements, February 2009

• ACHC Accreditation Review, February 2009

• Leadership Development, March 2009

• Conducting Employee Performance Evaluations, Fred Pryor Seminar, March 2009

• CMS Recorder Procedure, June 2009

• New RX/LMN/DTC, June 2009

• GP10 Overview, July 2009

• Business Overview and General Business Practice, October 2009

• H IPAA Privacy and Security Basic Training, October 2009

EDUCATION:

Evans High School 1989-1993 Orlando, FL

High School Diploma

REFRENCES:

Available upon request.

Contact this candidate