Customer Service Representative

Carmen M. Schreane **** Salmon Ln Ooltewah, TN ***63 **********@*****.*** 423-***-****

PROFESSIONAL EXPERIENCE

Memorial Health Care System- Chattanooga, TN Manager/Contracts & Compliance Dec 2007 – Dec 2008

The Vice President of Corporate Compliance and I drafted, negotiated, reviewed and revised nearly 500 Global Vendor Contracts based on a Compliance audit program and risk assessment OIG work plan. Restructured and implemented audit of 500 Global Vendors Contracts with payments of about 25-50 million dollars, totaling $1.5M in savings. Drafted Provider lease and construction agreements. Health Care regulations, and laws.

Kelly – BlueCross BlueShield of TN Customer Service Representative SCD Medicare Advantage October 23 2017-February 23 2018 Chattanooga, TN

●I answered phone calls from Members, Brokers or Member representatives and handled Blue Care Plus-DSNP members prescription drug coverage part D, Dental, Vision, Hearing, Over the Counter Supplies, Transportation and Wellness needs.

●as a Medicare Advantage Customer Service Representative in the Senior Care Division I worked in Facets and the Agent Work Space systems. I assisted members with obtaining Formulary exceptions, Prior Authorizations, and Tiering Exceptions from Express Scripts. I also advised members of their vision, dental and medical benefits. Additionally, I processed request for medical claim adjustments, appeals and grievances, LIS- low income subsidy,HIPAA, and worked with the Formulary, Utilization Management for prior authorizations daily and helped members understand their claims and billing copays and coinsurance patient responsibility.

SYKES – Customer Service Representative August 2016 thru August 2017

Customer service representative for Walmart.com. I answer phones, take payments, issue refunds, replacements and credits. This is a work from home position.

Convergys – Customer Service Representative 2011-2013

●Customer Service Representative for Directv. I Answered customer phone calls, set appointments and worked with customers who were upset about their service. ITook payments and trouble shooted for technical problems

EDUCATION

Saginaw Valley State University, B.A

University Center, MI 1991-1995 Bachelor Degree – Criminal Justice

Thomas M. Cooley Law School – Juris Doctorate 1999-2004 Business Law

Lansing, MI 1999-2004

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