Customer Service Representative
Resume:
Kristina M. Smith
Joliet, IL 60431
Email address: ***************@***.***
EMPLOYMENT
Wellpoint Networks, Inc
*** *. ****** ***** ***** 3900
Chicago, IL 60606
June 23, 1997 – October 24, 1998- State of IL Acct
January 31, 1999-March 31, 2007-ISG Claims Acct
November 22, 2008 –4/2/2010 – ARCUS Financial
Supervisor: Christine Depenbrok
Customer Service Representative Multi III:
Responds to customers, providers, agents, plan administrators, and member’s questions via
telephone and written correspondence regarding insurance benefits, provider contracts, eligibility
and claims. Analyzes problems and provides information/solutions. Operates a PC/image station
to obtain and extract information; documents information, activities and changes in the database.
I thoroughly documents inquiry outcomes for accurate tracking and analysis; develops and
maintains positive customer relations and coordinates with various functions within the company
to ensure customer requests and questions are handled appropriately and in a timely manner.
Researches and analyzes data to address operational challenges and customer service issues.
Provides external and internal customers with requested information. Proficient in all
basic/complex customer service functions. Receives and places follow-up telephone calls/e-
mails/letters to answer customer questions that are routine in nature. Uses computerized systems
for tracking, information gathering and troubleshooting. Requires an extensive knowledge of
company services, products, insurance benefits, provider contracts and claims. Seeks,
understands and responds to the needs and expectations of internal and external customers.
Performs other duties as assigned, updating the coordination of benefits, verifying whether the
member had other insurance through another carrier, or was Medicare prime, also updating the
precerts done through the Utilization management, and put into the Star system. The Hipaa
guidelines is a privacy act that must be followed and documented each and every time a call is
received and inquired about, whether it be from a policyholder, provider, plan administrator, or
agent.
Customer Account Representative III
As a customer account representative I deal with Chase J.P. Morgan and Arcus Financial health
savings accounts. I send paylists out to employer group representatives, advising them of new
enrollee’s added/deleted to the group; in order for the employer to fund their health savings
account. I advised the employer the ways of funding the account either doing an ACH or writing
a check attached with a deposit slip with the client account number and the members account
number. I educate brokers, employers and members the advantages and benefits of having a
health saving account. I update excel spreadsheets for certain items that need to be tracked and
detailed. I advise members of their account information, balances, any and all transactions that
they request; verifying all personal information before banking information can be given out.
United Health Group
233 N. Michigan Avenue 10th Fl
Chicago, IL 60601
Marketing Coordinator
November 5, 2007 –November 22, 2008 – Evercare IL
Supervisor: Michael Calogero/Chad Koenekamp/Maggie Del Real
Primary responsibilities include loading leads into the Seibel sales management system, sending
out enrollment packets, new facility letters, and other mailings that are requested.
Communicating with nursing facilities to obtain new lead information, updating and producing
reports, answering phones and assisting callers with questions and their claims issues. Managing
calendars and making appointments for Account Executives and developmental manager; and
coordinating marketing events or nursing home events. I ordered for luncheons for catering
events for potential clients and meetings. The Concur business tool was used for business
expenses done by the department, ordering supplies and other marketing materials for the
department as needed.
EDUCATION
Joliet Junior College
1215 Houbolt Avenue
Joliet, IL 60435
Personnel Management
Certificate of Achievement in Personnel Management (December 1995).
Health/Life License
REFERENCES
Available on request.
Contact this candidate