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Customer Service Representative

Philadelphia, Pennsylvania, United States
28-30,000 annually
January 09, 2018

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H: 215-***-**** C: 267-***-**** Obtaining an entry level position in the Customer Service field that hasroom for growth and advancement.

Customer service expert

Active listening skills

Seasoned in conflict resolution

Sharp problem solver

Courteous demeanor

09/2014 to 04/2017 Front Pharmacy Clerk Prior Authorization Optum RX - Philadelphia, PA

Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends

Deliver all information and questions in a positive, conversational and compassionate manner to facilitate developing a relationship with the provider, while providing the best customer service experience possible Focus on resolving issues on the first call, navigate through the appropriate computer system(s) to identify the current status of the issue and provide appropriate response to caller

Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)

07/2012 to 09/2014 BTSOperations Customer Service Rep Sr Bank of New York Mellon - Philadelphia, PA

Answers incoming calls from Brokers, clients, merchants and other financial institutions.

Calls are related to checking, debit card, ACH and bill payment. Adhere to required call technique and provide excellent customer service. Works under limited supervision and no instructions are needed on routine work, and general instructions are given on special assignments. Good knowledge of the job.

Substantial acquaintance with and understanding of general aspects of the job with a limited understanding of the technical phases of the job. Requires a high degree of accuracy.

Assists new employees on training and development. Assists manager and supervisor in monitoring the daily activities of the EDUCATION AND TRAINING

group, including positioning reps in various queues. May assist with follow-ups (customer call-backs), shares product and procedural knowledge with less experienced staff members. Pleasant and professional phone demeanor, strong customer service skills, the ability to adapt quickly to frequently changing procedures. Representatives must be able to determine why a transaction was declined, as well as assist customers with recognizing unfamiliar charges. Representatives should be able to explain various merchant attributes and the issues that arise when attempting to complete certain transactions. Other potential challenges include assisting customer with emergency card replacement and issuing expedited cards.

Occasional need to take escalated calls.

This position is integral to the achievement of our departmental service level goals and supporting staff.

In addition to communicating externally with customers, brokers, and merchants, representatives must also communicate professionally and effectively with other departments, such as check fraud, adjustments, debit card disputes and fraud investigation.

11/2011 to 07/2012 Pest Control Technician

The Pest Bureau - Columbia, SC

Pest control service in the Philadelphia Area, and surrounding counties. Bed Bug extermination Rodent control Proper ty protection from all types infestations, and pests.

09/2006 to 05/2011 Provider Service Representative Ameriheath Administrators - Ft Washington, PA

Handling of benefit contract disputes, appeals, preexisting conditions, other party liability and new or outstanding claim processing issues. Point of contact for AIG/ ARM accounts.

Worked directly with reps from ATLAS and ALICO to ensure claims processing issues were resolved.

Extensive knowledge of AHA, ICHP, and AIG/ ARM groups pertaining to medical benefits, provisions and outcome of claim processing. Work directly with group advisors, plan administrators, and HR personnel to ensure the correct handling of benefit and claim issues, plan specifications and delegation of all necessary plan changes.

Responsible for all incoming correspondence in regard to verifying benefits, payments and claim processing issues.

Point of contact for all callbacks to members and providers with claim and policy inquiries.

5 years' experience with AHA, ARM Groups Accelerated in 4 months to Point of contact for ARM (Adventist Risk Management). Extensive knowledge with ARM groups.

1987 diploma

West Catholic High School - Philadelphia, PA

1991 Associate Degree

National Education Center Philadelphia PA

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