Customer Service Insurance
Resume:
David Goldberg
Acton, MA ****0
T: 401-***-****
E: ***************@*****.***
SUMMARY
Highly experienced call center professional capable of utilizing excellent customer service skills with a proven track record to resolve issues with patience and efficiency.
EXPERINCE
Customer Service, Alegeus Technologies LLC, Waltham, MA 2016 – 2017
Handled calls regarding Blue Cross Blue Shield MyBlue Wellness program.
Reviewed Health and Wellness incentives available to members and discussed eligible expenses payable by the Health and Wellness program.
Resolved issues regarding receipt of health and wellness incentives to members.
Resolved incorrect payments disbursed to providers and vendors.
Service Advisor, MultiPlan, Bedford, MA 2006 – 2016
Documented provider issues and routed cases for resolution.
Advised callers on how to submit corrections of claims pricing, submit demographic updates of tax identification numbers, and submit address corrections.
Provided up-to-date information on requesting fee schedules and submitting fee schedule complaints.
Assisted callers with identifying and resolving credentialing and re-credentialing issues resolving application processing delays.
Advised callers on contract disenrollment procedures.
Referred members to network providers.
Sent members and providers to insurance carriers for benefit issues.
Customer Service Rep, Private Healthcare Systems, Inc., Waltham, MA 1995 – 2006
Initiated patient precertification process.
Collected and confirmed demographic information.
Completed notifications for specific unchallenged procedures.
Educated callers on precertification process.
Provided referrals for members to network providers.
Referred members and providers to insurance carriers for benefit issues.
Temporary CSR, Private Healthcare Systems, Inc., Waltham, MA 1994 – 1995
Referred members and providers to insurance carriers for benefit issues.
Bachelor of Arts, Political Science
University of Massachusetts, Amherst, MA
Associate of Arts, Liberal Arts
Roger Williams College, Bristol, RI
Microsoft Office, including Word, Excel, PowerPoint, Access, and Outlook. Facets. Service Tracking.
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