Customer Service Representative
Resume:
Diane R. Paul
Harrisburg, PA *****
*****.********@*****.***
Summary
A business professional with experience in analysis, testing, research,
customer service, and administrative duties. A knowledge-seeker with a
continual desire to learn and grow. Strong communication skills with a
particular emphasis in all facets of business writing and editing. Adept
at communicating and interacting with individuals of all backgrounds and
levels of business.
Technical Skills
SharePoint, ClearQuest, Outlook, Photoshop, Microsoft Office Suite
(Outlook, Word, Excel, PowerPoint)
Education
University of Phoenix - Masters of Business Administration, 2013
Susquehanna University - Bachelor of Arts, English, 1992
Professional Experience
Highmark, Inc., Camp Hill, PA
2013 - 2014
Associate Business Technical Analyst
Member of a project team tasked with the development and implementation
of a new Customer Service Call Center platform.
. Collaborated with members of the business and technical project teams
to create high quality test scripts for use in detecting defects
during the development of the customer service platform.
. Analyzed defects and determined next steps for the correction of
detected issues. Ensured that solutions were effective via regression
testing.
. Followed quality standards and best practices in the development of
new test cases and in the editing of existing cases to ensure
consistency and maintain quality standards throughout all phases of
the project.
. Performed peer review and editing of test scripts. Provided feedback
to peers and the Team Lead for the purpose of maintaining quality and
consistency throughout all phases of the project.
United Concordia Companies, Inc., Harrisburg, PA
2009 - 2013
Credentialing Specialist
Performed credentialing tasks and evaluated site audits for Dentists and
dental offices requesting participation in United Concordia's dental
insurance networks.
. Verified Dentists' qualifications via research of education and
residency, licensure, and other requirements. Researched and analyzed
discrepancies, license actions, and malpractice claim settlements.
. Researched, compiled, and presented complex cases to senior-management
committees for review and determination of participation status.
. Selected to create, edit, and maintain departmental documents and
manuals.
. Collaborated in the implementation of new processing systems and
procedures and the conversion of provider data to accommodate new systems
and procedures.
Capital Blue Cross, Harrisburg, PA
1992 - 1999
Customer Service Representative, Specialized Support 1994 - 1999
Processed customer service inquiries, questions, and appeals related to
claims and enrollment issues.
. Selected as the dedicated representative to service Capital Blue Cross
employees.
. Chosen as a representative to handle inquiries received from sources such
as the Pennsylvania Insurance Department and political figures.
. Researched, complied, and presented complex cases or otherwise difficult
issues to the Appeal Review Committee for determination. Collaborated
with various departments including Claims, Account Administration, Major
Medical, and Legal to carry out the committees' determination.
. Authored individual written responses to customers, Capital Blue Cross
employees, the Pennsylvania Insurance Department, and Legislators.
. Selected to create, edit, and maintain training manuals and perform peer
training.
Administrative Support Staff (Team Librarian) 1992 - 1994
Performed a variety of administrative and clerical duties for Managers,
Supervisors, and Computer Programmers within the IT department.
. Produced and delivered various documents, such as project proposals,
memorandums, and miscellaneous correspondence.
. Created and maintained the IT Department Procedure Manual.
. Maintained an inventory of office supplies and ordered supplies as
needed.
. Coordinated maintenance and service calls for office equipment.
Contact this candidate