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Customer Service Staff

Location:
Fort Lauderdale, Florida, United States
Salary:
$17 or more
Posted:
November 29, 2017

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Resume:

Altamease Hayes-Perkins

ac3ix3@r.postjobfree.com 941-***-****

Career Summary

Well-rounded Professional seeking to join the team of an established company where, I can offer my talents and abilities to help you meet your company goals. Past Roles of mine include close to 10 years of Legal Management experience, Supervisor of Customer Service, Medical Billing experience, as well as several years of practice in Data-Entry/Clerical roles.

Key Skills & Knowledge Areas

Leadership & Management

Staff Training & development

Customer Relations

Grievances & Escalations

Medical Terminology

Insurance Verification

Data-Entry & Typing Skills

Office Equipment Operations

Proficient in the use of computers and technology

High-volume inbound & outbound calls

Team Player

Work Experience

Convey Health Solutions 3/2016- Current

Supervisor

Resolve escalated Grievance calls from Members/Non-Members/Pharmacies/Physician’s

Conduct Supervisor callbacks when resolution was not gained during initial call

Communicating of job expectations

Enforce Policy & Procedures

Conduct One on One Meetings with Team Leads and Member Service Advocates to ensure he/she is following Policy & Procedures and stays abreast with all new information

Monitor calls by Side-jacking to identify reasons for areas of opportunities in Quality and overall performance/Check for outliers in all areas where goal is not met

Adjust/Approve missed punches in ADP

Submission of Time-Off Request

Conduct Performance Reviews

Ensure all employees are following their assigned breaks/Lunches to stay within the Schedule Adherence

Follow-up on email requests

Review Error Report

Approve/Deny Pharmacy Overrides

Maintain detailed documentation for process, procedure, performance, behaviors and incidents

Convey Health Solutions 09/2014 – 3/2016

Licensed Health Insurance Agent/Mentor

Enrolled Medicare/Medicaid qualified individuals in a Prescription Drug Plan

Explained the benefits of each prescription Drug Plan available

Provide information regarding the Formulary/ Tiers for medications

Informed members/potential members of drug cost

Specified whether a particular medication was/was not covered under plans available

Advised individuals of their Co-Pay, Deductible and Out-of-pocket expenses they would incur under each plan

Inbound/ Outbound Call Customer Service

Document all call information according to standard operating procedures

Entered/Verified personal information

Maintained patient and proprietary information

Resolved pharmacy issues from members, providers and pharmacies: determine the cause of the issue, select and explain the best solution to solve the issues

Submit requests for Prior Authorizations, Quantity Limit, Step Therapy and Non- Formulary Exception requests

Provest, LLC- 1st 08/2007- 02/2014

Shift Team Leader (Supervisor)

Direct and coordinate the production operations for a Process Service Company that processed and delivered legal documents for subpoena, wage garnishment, foreclosures, and pretrial cases.

Managed the processing of Affidavits that serviced our Independent Contractors

Recognized and resolved problems affecting production including schedules, staff and quality

Followed up on issues current or past in a timely manner to ensure resolution

Proofed Affidavits for quality and accuracy

Monitored staff's performance

Conducted and identified training needs of my staff

Fostered and reinforced a Customer Service culture within my staff

Maintained detailed documentation for process, procedure, performance, behaviors and incidents

Responded and accurately answered correspondence through verbal, written or emails

Optimized staff's performance through written goals and expectations

Verified and Approve time in ADP



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