Customer Service Representative

SHUREESE M. REYES

***** ************ ****** *** *** TAMPA, FL 33618

813-***-**** *********@*****.***

CareCentrix 08/2012

Present

Patient Account Services

•Answer inboud calls from patients regarding the bills they are receiving from CCX

•Explain to patients their out of pocket cost before they receive durable medical

equipment or home health services

•Create itemize statements and send out to patients

•Process credit card payments made over the phone and received by mail

•Assist the Research Department with their work

Freedom Health Plans 07/2011

08/2012

Concierge Representative

•Answer 60 70 inbound calls a day from Medicare members and providers

•Advise members/providers of the benefits and copays/coinsurance for services

•Answer questions regarding claims

•Work on several outbound projects when needed

•Reviewn my teams PCP changes every day to insure they are correct before they are

processed in the system

•Take orders for Over The Counter (OTC)products and diabetic supplies

•Answer questions from prospective members and connect them with a sales agent

Everest University Online 03/2010

06/2011

Student Finance Representative

•Review financial applications and disclosure statements for completeness and

accuracy

•Inform students of their financial obligation, the institutions financail options, and

financeial policies and procedures as related to their educational expenses

•Unofficial team lead for my Division

HealthPlan Services 06/2009

03/2010

Billing and Enrollment Customer Care Associates

•Responds to member inquires via telephone

•Answer members questions relating to the premiums they pay

•Answer members questions relating to enrollmemt such as adding/removing

dependents

WellCare 12/2005

06/2009

Grievance Coordinator

•Investigate and resolve member complaints

•Make decisions that are consistent with the concept of a win win win for members,

associates, and WellCare.

•Assist with departmental mail

•Train new associates and coach associates who need improvement with their work

Senior Customer Service Representative

•Primary contact for escalated calls and/or escalated issues

•Handles calls for multiple lines of business as assigned

•Assists members when they come to the corporate office

Customer Service Representative

•Take inbound calls from members and providers

•Logs, tracks, and document all issues utilizing online systems and established

procedures in accordance with all applicable guidelines and requirements

10/2001

JP Morgan Chase

07/2005

Retirement Services Representative

•Answer calls regarding the procedures and IRS regulations regarding IRAs, SEPs,

and QRPs

Fraud Prevention Analyst

•Make outbound calls to contact cardholder regarding suspicious activity on there

credit cards

•Mail out letters when the member cannot be reached by phone

•Place authorization flags on accounts that have the potential to be fraudulent

•Also work written reports to determine if fraud has occurred on those accounts

Fraud ACD Representative

•Answer a high volume of incoming calls from cardholders whose accounts appear to

have fraudulent activity

•Remove authorization flags from accounts that have been verified

•Close credit card accounts that have fraud to start the investigation

EDUCATION

University of Tampa

Bachelors of Science

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