Customer Service Representative

Melanie Smallwood

*** ****** ****** • Bridgeport, CT 06607

Phone 203-***-****

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

Summary

Offering over ten years of experience in a busy office environment and providing exceptional support. To obtain a full-time position in an office setting with a company offering a variety of challenges and responsibilities where my skills and abilities can be fully utilized

Work Experience

Associate Provider Installation Specialist

April 17, 2017 - present, United Health Care, Shelton, CT

Installation and administration of providers contracts

Structure and billing set up

Eligibility and credentialing collection

Database loading for provider contracts and amendments

Provider Installation Representative – TRICARE

October 2012 – April 17, 2017

Processed TRICARE provider contracts into PIMS for various entries, e.g., fee schedule changes, demographic changes, problem resolution, and contract/provider terminations for various specialties, including OHBS, groups and facilities.

Used NDB as a source of verification

Investigated non-standard requests and problems, with some assistance

Responsible for various activities related to the provider network database which include: database maintenance, reporting and extracting data for various reports and analyses; overall provider contract loading and processing using PIMS and NDB

Ensure to synchronize system platforms (PIMS and NDB) and excel TriCare West projects.

Reviews account records to ensure accuracy and completeness

Prioritize and organize own work to meet deadlines.

Work daily with Microsoft Office, Word, Excel, internet browsing, and email

Customer Service Representative

March 2012 – October 2012, LogistiCare, North Haven, CT

Obtained and provides information related to accounts, procedures, and regulations to both customers and providers.

Handled heavy phone call volume,

Entered of all customer service requests into the data management system

Made outbound provider calls

Effectively multi-task and remained focused and productive

Worked well under pressure with conflicting demands, deadlines, emergencies

Administration and Recruiting Clerk

11/2008– 5/2010, U.S. Department of Commerce, Bridgeport, CT

Performed routine clerical tasks required in the collection, control, review, processing, and reporting of personnel and payroll data for approximately one thousand employees.

Carried out employee selection and hiring functions, including processing personnel actions.

Maintained personnel files, handled sensitive information, and administrative records

Answered incoming calls, and provided customer service by answering callers' questions and scheduling applicants for the employment test.

Maintained recruiting files, conducted quality control inspections on application folders, and keyed application data into a tracking system.

Internet Response Team and Customer Service Representative

06/2000– 5/2008, Health Net of the Northeast, Shelton, CT

Handled all phases of member and provider inquiries received in person, by telephone, and email on multiple products.

Responded to customer inquiries and complaints (i.e. medical claim inquires, policy inquiries, and account updates) in a customer focused manner.

Verified pre-authorizations

Worked with all areas of the Company to obtain pertinent information to serve members

Used the necessary systems to ensure claims are properly processed. Used computerized system for tracking, information gathering, and/or troubleshooting.

Order Entry

5/1999 – 6/2000 Carbtrol Corporation, Westport, CT

Entered job orders into the company database and providing support for customers and vendors alike should they contact the office. Completed banking and billing transactions.

Office Clerk

09/1991 – 10/1998 United States Surgical, North Haven, CT

Communicate with employees, and other individuals to answer questions, explain information, and address complaints. Answer telephones, direct calls and take messages. File records of office activities. Operate office machines, such as photocopiers and scanners, facsimile machines, voice mail systems and personal computers. Maintain and update filing, inventory, mailing, and database systems. Open, sort and route incoming mail, answer correspondence, and prepare outgoing mail. Deliver messages and run errands. Inventoried and order materials, supplies, and services. Troubleshoot problems involving office equipment, such as computer hardware and software.

Education

Training Direct, Bridgeport, CT - Certified Billing/Coding 2013-2014

Butler Business School, Bridgeport, CT – Certificate ~ Secretarial 1997 – 1998

Warren Harding High School, Bridgeport, CT – Diploma 1987 - 1991

Technical Skills

Microsoft Excel ~ Microsoft Word

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