Customer Service Sales
Resume:
Esther Roman
Goshen, NY
**********@*****.*** - 845-***-****
WORK EXPERIENCE
Clinical Appeals Coordinator
Mcbee Associates - New York, NY - 2011 to Present
Senior Customer Service Team Lead
Patient Account Services - Houston, TX - 2007 to Present
* Active managerial role in the day-to-day operational functions in achieving daily call center service levels
and performance guidelines.
* Delivered on the job training and classroom instruction in technical subject matter, system applications,
corporate initiatives and professional development. Designed training materials and job aides.
* Assigned multiple projects and department initiatives, responsible for resolving Hospital inquiry escalations,
facilitated resolution of issues between staff liaisons and the client. Managed and ensured timely responses
from the client.
* Managed Email Billing Solutions application. Responded to complex billing cases via email within at two-day
business timeframe in a professional and efficient manner.
* Assisted in the redesign and development of department workflows and policy & procedures - conducted
training to team on new processes.
* Handle inbound and outbound calls in a blended environment with excellent proficiency.
* Effectively use all supporting applications for call tracking and history.
* Assess customer complaints, handle billing inquiries and provide adequate resolution.
* Proficient in overcoming customer dissatisfaction, providing exceptional follow-up and customer service
retention.
* Persuasive communicator with well-developed presentation and negotiation skills. Able to develop productive
relationships with colleagues, customers, direct reports and staff at all levels.
* Oversee daily operations and responsibilities of Customer Service department - attendance tracking and
monitoring.
* Training, monitoring, educating and accessing competency of staff.
* Provided consistent floor supervision of staff.
* Assist staff in achieving personal mastery of their job responsibilities, ensuring they meet all performance
standards.
* Provided timely and consistent feedback to staff.
* Ensured staff met and or exceeded the department monitoring program goals - by conducting remote
monitoring, side by side monitoring, and calibration sessions.
* Provided daily, monthly, quarterly and annual analysis to management.
* Analyze data and report to management agent performance, areas for improvement and trends.
* Assisted management team with staffing decisions.
* Demonstrated strong leadership, analytical, and management skills that always remained in line with the
goals and mission of the department and Client
* Ability to research, document and resolve in-depth customer complaints and grievances
* Exhibit expert ability to understand, explain, update and initiate resolution for all types of billing inquires.
* Provide leadership in supervisor's absence.
* Exceeded productivity levels as it relates to lines of business and operational objectives
* Maintain quality, abandon rate, maximum talk time, and other service level standards
Customer Service Rep
Patient Accounts Services, LLC - Houston, TX - 2007 to Present
Team Lead
Customer Service - Call Center
- 2007 to 2008
* Answer and handle member calls with proficiency in all areas of benefit resources
* Consistently provide accurate information to members
* Effectively mode and make decisions consistent with the department's framework.
* Answer phone calls from members, and service providers regarding a variety of Ability benefit and coverage
related questions in a courteous, professional manner
Customer Service
United Healthcare - Houston, TX - 2006 to 2007
Customer Service Liaison
- 1994 to 2006
* Assist sales associates with all phase of orders
* Order Entry
* Set up appointments for Sales Associates
* Maintain patient files
* Verify insurance coverage, obtain referral, and pre authorizations
* Pre qualify patients for service to be rendered.
* Obtain supporting documentation from therapist, doctors need for processing orders
* Process service for the Handicapped
* to research, document and resolve in-depth customer complaints and grievances
* Exhibit expert ability to understand, explain, update and initiate resolution for all types of billing inquires.
* Transfer calls to appropriate staff as required
* Identify, research and resolve customer issues
* Follow-up on customer inquiries not immediately resolved
* Maintain up-to-date documentation for use during calls
* Schedule equipment delivery to patients and hospitals
* Obtain claim status via phone, internet and or/ fax
* Obtain supporting documents regarding insurance follow up.
Customer Service
Landaulet Metropolitan - Mount Vernon, NY - 1999 to 2005
Customer Service
Homecare Supply - Hicksville, NY - 1994 to 1999
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