Customer Service Quality Assurance
Resume:
*** ****** **** ***** ******* AA
Camp Hill, PA **011
************@*****.**
m
Objective Claims Analyst with extensive experience in customer relationship
building, strategic planning and database management. Proven
abilities in process improvements, proposal development and customer
service resulting in customer retention and revenue growth. Adept at
software training for new employees and departments. Performed
clerical support for customers and management. Ensured all calls
were monitored for quality assurance. Excellent communication,
problem resolution and team collaboration.
Data
Compilation Deadline Driven
Regulatory
Compliance Customer Acquisition
Experience 2010- 2013
Accounts Rep I Crump Life Insurance Services
Harrisburg, PA
.Perform outbound calling to current customers to notify them of new
campaigns, products, and provide timely information on cases
currently being processed
. Perform outbound calling to prospective customers to introduce
them to the Crump Endorsed account program
. Participate in ongoing training to develop skills
. Maintain performance standards
. Utilize CRM system
2010
Receptionist Maria P. Cognetti Esq.
Camp Hill, PA
Answer multiple phone lines, screen and direct calls
Provide information to callers
General administrative and clerical support
Prepare letters and documents
Take and relay messages
Ensures knowledge of staff movements in and out of organization
Deal with inquires from public and customers
2009 Mechanicsburg Eye Associates Camp Hill, PA
Optometric Assistant
Responsible for maintaining and upkeep of the examination room
equipment
Maintained and filed patient records
Answered multi-line phone system
Responsible for scheduling patient appointments, greeting patients
and patient billing
Performed other duties as assigned
2007-2009 William-Sonoma Camp Hill, PA
Customer Service Representative
Resolved customer requests, questions and concerns frequently
requiring analysis of situations to determine best use of resources
Served as liaison between the customer and various departments
Provided pricing and delivery information, processed orders, and
prepared cash reports
Set up new accounts, maintained records, prepared reports and
performed work processing assignments and related clerical duties.
2004-2007 Capital Blue Cross Lemoyne, PA
Senior Claims Analyst
Responded to provider phone calls and correspondence including but
not limited to, claim adjustment requests, appeals, corrected
claims, timely filings, and claims projects
Maintained current knowledge of benefits, provider network
development and contract issues and regulations
Adhered to HIPAA guidelines
Reported problems and trends to senior staff along with
recommendations for process improvement
2004-2005 Synertech Harrisburg, PA
Claims Analyst
Responsible for accurately and efficiently entering and adjudicating
claims
Responded to telephone inquiries from service providers regarding
all aspects of benefits and claims assessment
Researched and compiled information from various sources to resolve
inquiries and claim discrepancies, consulted with senior staff if
assistance was needed
2001-2004 ACS Camp Hill, PA
Enrollment Specialist
Maintained provider information on all claims and provider databases
Assisted customers with enrollment into suitable HMO plans
Answered and directed incoming calls on multi-line phone
Maintained confidentiality at all times in accordance with company
policy
Education 2009-2011 Associates Degree - Human Services Mgmt. University of
Phoenix Harrisburg, PA
2005 Certificate of Completion - Microsoft Word, Excel
PowerPoint, Access Grace Temple COLG - Steelton, PA
2004 Certified Tax Preparer Jackson Hewitt Tax Service -
Harrisburg PA
2002 General Education Degree HACC - Harrisburg, PA
References AVAILABLE UPON REQUEST
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