Customer Service Representative

LAKINYA JOHNSON

**** *********** ***, *** *****, CA 95758 H: 916-***-**** *******@*******.***

SUMMARY

Results-Driven Claims Representative with proven ability to establish rapport with clients. Reliable

Customer Service Representative with extensive track record in demanding sales and account

management environments.

SKILLS

Strong organizational skills

Active listening skills

Customer service expert

Microsoft Office Suite

Client Relations

Computer Proficiency

Medical Claims Processing

EXPERIENCE

03/2013 to 08/2018 Customer Service/Claims Representative/Appeals & Grievance

BlueShield Of California El Dorado Hills, CA

Services plan members by addressing inquiries through different channels (e.g., live web-based applications, telephone and email), resolving issues, and educating members. Ensures proper member services procedures and monitors service levels. Correspondence/Phone Support - Responds to and resolves various customer inquiries via telephone and correspondence, and resolves claims problems within established production and quality standards. Answers incoming calls and written requests for information from members or providers promptly and accurately. Composes routine and non-routine correspondence to answer member inquiries that require a written response. Coordinates with other departments to ensure timely and appropriate responses. Expedites and resolves complex issues and initiates claim adjustments.

11/2012 to 03/2013 Customer Service Representative (Temp to Hire)

BlueShield Of California/Kelly’s El Dorado Hills, CA

My primary function was to accurately, completely and thoroughly answer, process and document inbound and outbound calls in a fast-paced call center environment. While on the phone, I accessed policies, procedures and information in the facet and CRM software systems. I assist members with changing healthcare providers, mailing updated ID Cards and coordinating benefits when needed.

06/2011 to 10/2011 Claim Processor

State Farm Insurance Bakersfield, CA

Conducted claim and estimate re-inspections. Explained premiums owed to

policyholders, agents and underwriters. Obtained all necessary information to

complete proper evaluation of injury claims.

03/2009 to 04/2010 Account Executive

Comcast Sacramento, CA

Provided accurate and appropriate information in response to customer

inquiries. Collected customer feedback and made process changes to exceed

customer satisfaction goals. Addressed customer service inquiries in a timely and

accurate fashion.

04/2001 to 03/2009 Clerk

Fresno Unified School District Fresno, CA

Scanned and filed forms, reports, correspondence and receipts. Operated office

equipment such as copiers and fax machines. Performing various office duties,

such as typing, filing, proofreading, and Assisting the principle with completion of

documents and files for the entire school system. Answering multi-phone

lines, directing parents to the accurate school departments.

EDUCATION AND TRAINING

1998 High School Diploma: College Preparation

Fresno High School Fresno, CA, USA

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