Customer Service Manager
Resume:
MICHELLE TORRES
Wilmington, DE 19805
(Cell) 410-***-****
*********@*****.***
JOB OBJECTIVE:
To obtain a position where I can maximize my multilayer of management skills, quality assurance, program development, training experience, customer service, and a successful track record in the Office Manager Healthcare and financial environment.
EDUCATION:
Wilmington University
Wilmington, DE
Ongoing studies toward Masters Business Management May 2019 \
Goldey-Beacom College
Wilmington, DE
Bachelor of Science Business Administration/Concentration in Healthcare May 2015
WORK HISTORY
HBCS, Patient Account Representative, New Castle, DE May 2017 to Present
• Manage a high volume of in-bound and out-bound calls from patients, hospitals, and insurance carriers to resolve patient accounts and collect payment.
• Research alternate insurance or payment options available while navigating and updating multiple patient accounting systems
• Assess caller status to ensure the protection of patient privacy and compliance with State and Federal guidelines
Bank of America, Fraud II Associate, Newark, DE September 2014 – December 2016
Relocated
• Review Client credit card spending pattern history to determine if the system decline charges are valid or fraud
• Contact Client to review all decline charges to confirm fraud
• Contact Client when charges are refer and the merchant and not returned call
• File fraud claim in behalf of Client
• Close Client account and overnight a new card for all card holder
• If Client identify all charges are valid, update account by placing an override
SchagrinGAS, Office Manager Temporary, Middletown, Delaware, June 2013 – March 2014
Temporary
• Supervised, coached and developed a team of 14 employees
• Administered the employee scheduling Personal Time Off, tracked late arrivals, early departure, call outs, managing personal and medical leave such as FMLA, STD, workman comp and inputting time and attendance
• Handled complaints customers’ complaints and monitored and calculated customer’s year budgets
• Created and implemented new Policy and Procedures and other duties
Westside Family Healthcare, Office Manager, Wilmington Delaware, January 2008 - May 2013
• Supervised, coached and developed a team of 28 employees
• Administered the employee scheduling Personal Time Off, tracking late arrivals, early departures, call outs, managing personal and medical leave such as FMLA, STD, workman comp and inputting time and attendance
• Community Outreach
• Responsible for day-to-day employee performance management; holding employee one-on-one monthly meetings to
• provide the employees with monthly feedback and training assessments, providing Career path guidance to the employee based on the employee area of interest
• Handled complaints from patient, provider and other duties
• Ordering and distributing supplies to all departments
Diagnostic Imaging Associates, Office Manager, Wilmington Delaware, January 2007 – Dec 2007
• Supervised, coached and developed a team of 14 employees
• Administered the employee scheduling Personal Time Off, tracking late arrivals, early departures, call outs, managing personal and medical leave such as FMLA, STD, workman comp and inputting time and attendance
• Responsible for day-to-day employee performance management; holding employee one-on-one monthly meetings to
• provide the employees with monthly feedback and training assessments, providing Career path guidance to the employee based on the employee area of interest
• Handled complaints from patient, provider and other duties
• Ordering and distributing supplies to all departments
CIGNA Company 1991 - 2006
CIGNA Company, CIGNA International, Call Center Supervisor 2003 – 2006
• Supervised, coached and developed a team of 41 employees
• Administered the employee scheduling Personal Time Off, tracking late arrivals, early departures, call outs, managing personal and medical leave such as FMLA, STD, workman comp and inputting time and attendance
• Community Outreach
• Responsible for day-to-day employee performance management; holding employee one-on-one monthly meetings to
• provide the employees with monthly feedback and training assessments, providing Career path guidance to the employee based on the employee area of interest
• Handled complaints from patient, provider and other duties
• Basic Accounting
• Ordering and distributing supplies to all departments
Handled all Human Resource issues and disciplinary action
Sr. Customer Service Adjusters 2001 - 2003
• Reviewed the appeal claim to determine if an adjustment was needed \
• Provide Customer Service Associate feedback, coached and developed
• Handled Supervisor calls
• From time to time assist Customer Service Department with incoming
Customer Service Associates 1996 - 2001
• Handled a high volume of incoming calls
• Provide details benefits and claims status to Providers and card holder
• Forward any claims requiring adjustment
Priority Service Associates 1994 - 1996
• Handled all patient complaints calls.
• Performed adjustment if need based on the patient complaint
• Meeting supervisor to discuss on going pattern of errors being made by Customer Service Associate and Claims Processor
Sr. Customer Service Associate 1996 – 2001
• Handled all patient complaints calls.
• Handled incoming calls during high peak time throughout the day
• Train and Coach new hires
• Assist Customer Service Associate with questions
Claims Processor 1991 - 1992
• Review claim to determine if payment can be made
• Manually convert international claims to United States Currency
• Code Claims with the proper diagnosis and ICD 9
• Handled incoming calls from provider, employer, broker and card holder on the account assigned
• If claim was denied incorrectly, forward claim to Adjuster
SKILLS
• Proficient in Microsoft, Power point, X-cell, and Presentation
• Experience with IEX, PeopleSoft, Verint, Impact software
• Knowledgeable in Electronic Medical Record
• Skilled in Processing and Approving ADP Payroll
• Bilingual Spanish and English reading and writing
• Grant writer/proposal
• Community Outreach
• Sars
• SAP
• Strategic Planning
• Business Proposal
• Writing non-profits By-Laws
• Assisting no-profit in filing 501C3 application
• Accounting
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