Customer Service Representative
Resume:
STEPHEN CULLITY
Orange Park, FL 32073
904-***-**** (h) or 314-9597 (c)
abjlvd@r.postjobfree.com
SUMMARY OF QUALIFICATIONS
. Twenty- two years experience in customer service including direct,
correspondence, and call center activity, handling an average of 60 -
75 calls per day.
. Extensive experience in claims processing, resolving disputes, benefit
inquiries, referrals, and appeals.
. Additional experience in collection of past due and overpaid accounts
to providers and reconciliation of patient /client accounts.
. Detail-oriented, team player with multi-tasking capability.
. Excellent communication skills.
RELEVANT SKILLS & EXPERIENCE
CUSTOMER SERVICE
. As in-bound Call Center Agent responsible for reconciliation of
customers' financial accounts.
...Received inbound calls from customers answering questions regarding
signup options, plan coverage and claims; explain program, coverage gaps,
and how to apply for subsidies from State and Federal agencies.
. As Customer Service Representative processed claims, established
eligibility for providers, referrals, and benefit inquiries.
...Researched, analyzed and resolved claims that pended/denied involving
interaction with physician centers, referral nurses, and physician
reviewer.
. As Provider Relations Customer Service Representative researched,
documented and resolved issues and billing errors; make adjustments,
complete telephone reviews and research client history files.
...Expert knowledge of Medicare Part B policies and procedures and CPT
coding; provide education to provider community to ensure efficiency and
accuracy of Medicare billing.
. As Coordination of Benefits Specialist handled calls from
representatives, providers, plan members, and employers; responding to
inquiries, verifying benefits, handling grievance issues, claims
processing, and financial recovery.
...Expert knowledge of benefits laws, regulations, and guidelines for all
lines of business concerning pre-existing and HIPAA rules establishing
subjectivity to investigations.
. As Pharmacy Customer Service Rep provided education and resolution of
member and provider inquiries regarding the adjudication of prescription
drug benefits under Medicare Part D.
SUPERVISION
. As Team Lead analyzed and evaluated customer service operations and
performance; daily, weekly, and monthly reporting of statistical
information to Team Manager, advising of special needs or trends in the
unit.
STEPHEN CULLITY
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ADMINISTRATIVE / TECHNICAL
. As Freight Associate/Stocker/Sales unloaded incoming shipments; restock
inventory as needed.
Assisted customers with questions regarding availability of products,
store location and features.
As Mailroom Associate, assured automated mail router properly sorts to
correct zip codes throughout
the country; resolve discrepancies insofar as incorrect mailing
locations.
EMPLOYMENT HISTORY
October 2009 ~ December 2009 Customer Service Medicare
Convergys
May 2009 ~ Present Volunteer Office Staff Member
Fish for Life
February 2008 ~ May 2009 Freight Associate/Stocker/Sales
Home Depot
October ~ December 2007 Call Center Agent
Citicards
March ~ October 2007 Mailroom Ops Associate Randstad
U.S.A.
March 2006 ~ January 2007 Medicare Part D CSR Kelly
Services
July 2002 ~ May 2005 Provider Relations CSR First
Coast Service Options
November 1990 ~ May 2002 Customer Service Rep Humana
Health Care Pharmacy Division CSR
Customer Service Team Lead
Coordination of Benefits Specialist
EDUCATION
A.A. Business Administration, Valencia Community College, Orlando, Florida
[1975]
MILITARY SERVICE
U. S. Army Reserves
Communications Specialist, Longwood, Florida [1990 - 1991]
U.S. Army National Guard
Aviation Life Support Equipment Specialist, Orlando, Florida [1984 - 1986]
Communications Specialist, Fort Gordon, Georgia [1979 - 1984]
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