Customer Service Sales

Katherine Le 714-***-****

**** ******* ***** ***** **** 102 Las Vegas Nevada 89156 **********@*****.***

Objective

Seeking a position where my extensive experience will be further developed and utilized with an opportunity for growth within the organization.

Skills

Familiarity and experience in working with customer service / call center environment utilizing various forms of complaint management and conflict resolution to handle various complex and time sensitive issues.

Developed ability to work in a fast-paced atmosphere.

Experienced in handling confidential paperwork.

Effectively handled phone messages and delivered urgent messages promptly.

Established excellent customer rapport with customer base.

Experience with sales/marketing, processing and order management functions at many levels of the order process.

Knowledge and experience with various management software applications: Microsoft Office, Excel, Outlook, Word

Typing (45+ wpm)

Strong knowledge of medical and financial field

Language Fluency –Vietnamese and English

Detail Oriented

Meeting and exceeding personal customer service standards set by management; upholding a standard of excellence by providing a rewarding customer service experience.

Professional Experience

Californina Choice, Orange, CA

July 2014 to current

Customer Service Representative

Broker license#0k89245

Acheivements

Providing excellent customer service and maintain a high level service to brokers, groups, and members

Provide clear and explicit documentation

Achieve productivity goals and resolving issues in a timely and efficient manner

Responsibilities

Handles calls from customers to resolve, educate, follow-up and respond to questions regarding CaliforniaChoice plan administration and procedures

Educate brokers, groups,and employee’s via telephone about Doctors, ID cards, RX problems, administrative procedures, dependent coverage, address changes, and benefit information

Follow-up calls from brokers regarding problems that their groups are groups and employee’s are experiencing

Responds to calls from providers about eligibility and benefits

Verify enrollments, benefits, and resolve claim issues

Expedite processing of enrollment and eligibility issues for employee’s

The Oncology Institute of Hope and Innovation, Long Beach, CA

February 2011-July 2014

Lead Authorizations Coordinator

Achievements:

Established and maintain a high level of patient and physicians satisfaction through daily interactions and exceeding daily productivity

Leading the authorizations team and trouble shooting, possible discrepancies between patients physicians and insurances

Responsibilities:

Lead and manage authorization team effectively and efficiently

train employees

Review authorization queue for applicable orders

Verify and comply with payer contractual authorization requirements

Submit authorization request timely and efficiently, ensuring proper documentation is included for review

Utilize website portal, and electronic options to submit authorization requests

Work with management to identify payer trends or potential issues

Demonstrate exceptional customer service skills in the performance of work assignments and duties

Scheduling and re-scheduling patients appointments with accordance with established protocols

Run daily logs for doctors and administrators 2-3 times a day

Verify patients eligibility through health plan and patients IPA

Maintain confidentiality of medical information

Alert staff, management and patients of any indentified potential coverage issues

Prospect Medical Group, Santa Ana, CA

2007-2009

Member Relations Representative

Achievements:

Established and maintained a high level of customer satisfaction in all interactions. Consistently met or exceeded daily and monthly sales/productivity goals.

Achieved productivity goals by utilizing sound telephone based approaches.

Developed strong product knowledge, offering customers the best services to fit their needs.

Responsibilities:

Provided prompt, accurate, and courteous customer service to clientele, in all manner communication and strict quality control guidelines.

Utilized various financial data management systems to provide in depth information to customers for retention. Processed various claims/transactions and identified opportunities to assist clientele where needed.

Maintains complete records on all accounts including, but not limited to, detailed documentation on all efforts, proof of timely filing, authorization hardcopies, correspondence from insurance for eligibility and benefits.

Garden Grove Unified School District, Garden Grove, CA

1999 – 2011 ( Part Time)

Instructional Aide

Achievements:

Expertise at selecting and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things.

Demonstrate ability to interact and communicate effectively with students.

Deep interest and joy in working with students.

Responsibilities:

Assist teachers and students in the office and classroom environment for clerical and administrative procedures as required.

Assist in the implementation of Individual Education Programs for students and help monitor their progress.

Support class teachers in photocopying and other tasks in order to support teaching.

Assist in the implementation of Individual Education Programs for students and help monitor their progress.

Cal Optima, Orange CA

2006-2007

Customer Service Representative

Achievements:

Experience with sales/marketing, claim processing and order management functions at many levels of the order process for member, providers, and health care networks.

Meeting and exceeding personal customer service and sales standards and those set by management, upholding standards of ethics and excellence above and beyond the standards of peers by providing a rewarding customer satisfaction experience.

Achieved productivity goals by utilizing telephone based approaches.

Responsibilities:

Researched and provided courteous, accurate and timely responses to inquiries by health plan providers and members as related to referrals, authorization, and eligibility inquiries.

Billers are explaining balances, reviewing accounts for accurate billing, handle and resolve disputes from patients and provider, forward escalated issues as required to customer services supervisors.

Verified members eligibility, insurance, benefits and coverage.

Handled high volume for internal/external customer base.

Education

Garden Grove High School, Garden Grove, CA

High School Diploma

1998

Coastline Community College, Garden Grove, CA

Currently Enrolled

Bachelors of Arts: Business Administration

References

References are available upon request.

Contact this candidate