CARLISHA N. MITCHELL
Customer Service Specialist with a can-do attitude and willingness to help at all times. Dedicated to providing excellent customer service and making operational and procedural improvements.
Proficient at Microsoft Office, especially Microsoft
Professional and mature
Word, Excel, and PowerPoint
Dedicated team player
Knowledge of operating standard office
Strong interpersonal skills
equipment, e.g. a scanner/printer
Excellent time management, organization, and
Claims appeal procedures
attention to detail
Insurance eligibility verifications
Clear verbal and written communication
Customer Service Specialist Manager
05/2015 to Current
Data Entry, Individual Medicare, Medicare Medical Claims and Benefits, Pharmacy Claims and Benefits, Medicare Supplements and IPA for several states, Billing and Enrollment Description: Inbound and Outbound calls for Individual Medicare members. Provide Medical and Prescription Benefits and Accumulations. Provide status on the processing of Medical and Prescription claims. Set up automatic payments as well as make one-time payments for members. Resolve member issues and answer questions to those who call on the member's behalf (POA/EOE) per HIPAA Guidelines set by Center for Medicare and Medicaid Services (CMS). Speak with providers in regards to eligibility for pharmacy as well as pharmacy claims. Completed tracking reports to keep up with individual and site wide performance and to make sure that agents are following normal procedures and protocols based off CMS and HIPAA. Developed and implemented policies, procedures and process improvement initiatives to improve retention rates and increase customer satisfaction.
Medical Office Administrator
05/2014 to 09/2015
Doctors Making House calls
Cooperated with Medicare, Medicaid and private insurance providers to resolve billing issues.
Scheduling appointments, medical procedures, medical equipment, etc. for patients in Assisted and independent
Received and distributed faxes and mail in a timely manner.
Customer Service Representative
01/2005 to 11/2009
Sport Endeavors, Inc.
Selling soccer and lacrosse clothing and equipment. Providing customer with information on new products.
Handle customer complaints in a professional manner. Selling of Gold Club membership to offer customers
special items and collect point for free products.
Education and Training
Associate of Arts
Piedmont Community College Roxboro, NC, United States