Customer Service Representative
Resume:
Angela Nicole McLaurin
Friendswood, TX 77546
********@***.***
Career Summary
Qualified Professional and Customer Service Supervisor with over 16 years
of experience interfacing with, and supporting, both internal and external
customers. Conduct presentations with poise and confidence to include
question and answer sessions. Able to read, comprehend and explain benefits
in a clear, concise, courteous and professional manner. Looking to secure a
challenging position where the utilization of my communication skills both
verbal and written, my excellent teambuilding experience and proven
abilities will be rewarded with long-term growth and advancement
opportunities
Professional Experience
Saks Fifth Avenue
Houston, TX
Command Center Analyst
July 2013 to December 2013 (seasonal)
Responds to technical customer inquiries reported via phone and/or other
means of notification, including observed facilitate customer resolution
without bias to the reason or legitimacy of the inquiry. Understand how to
access and interpret data in the Payment Authorization and Data Collection
systems. Also able to access and interpret data in Network and Server
monitoring tools. Utilize technical knowledge and skills to resolve 60% or
more inquiries without assistance. Recognize and react to system
performance issues that impact on-line users, applications or batch
processing. Actively monitor communication circuits and devices for
outages, interruptions, errors and patterns of each. Actively monitor
selected servers and other system devices associated with store and
corporate systems, applications and databases. Communicate with Computer
Operations, Helpdesk and affected users to make them aware of the issue and
related consequences. Provide timely feedback to associates to allow a fair
opportunity to address and recover form performance issues. Work with
Problem Resolution Coordinators to identify training opportunities and
documentation development.
Tried and True Healthcare Services Jackson. MS
Office Manager August 2011 to
Present Assisting with development and implementation of practice policies
to improve operations and patient care activities. Analyzing and evaluating
workflow to ensure maximum efficiency; Coordinating the scheduling of staff
and physicians to provide optimal support for the practice. Supervising
staff members. Monitoring and training support staff in execution of their
duties. Will initiate contacts and negotiate appropriate resolution
(internal and external) as well as receive and resolve inquiries and
correspondence from third parties and patients. The ability to analyze,
audit and reconcile an account is critical to this position. Conducts
duties in accordance with industry federal and state billing and
contractual obligations and in compliance with department policies and
procedures. Must demonstrate dependability and an ability to work
independently. Must be able to retain composure, meet deadlines, and
appropriately analyze, research, and resolve problems in a stressful
environment with constant work-related interruptions. Professionalism and
courtesy when communicating with patients and other external contacts,
primarily by telephone, displaying an attitude of proven, committed
customer service as well. Monitoring staff in correct use of policies and
procedures and electronic systems. Acting as Human Resource staff in
payroll accounting. Assigning and reviewing quality of work. Mediating and
resolving employee problems issues. Evaluating support staff performances
participating in the screening and interviewing of prospective candidates
for clerical and clinical positions and makes recommendations for
employment. Overseeing front end registration for patients and appointment
scheduling for patients. Participating in all day-to-day activities of the
office staff by assisting with patient reception, registration,
appointments and other patient care related activities when necessary,
including weekends. Ordering supplies and equipment; managing inventory,
physical space and environment of the practice including phones, equipment,
cleaning services, and ITS computer services.
Zimmerman Associates, Inc.
Alexandria, VA
FEMA Supervisor, Help Desk Specialist, Tier I & II
Jan 2009 to May 2011
FEMA Risk Map Customer and Data Services (CDS) Contract
Responsible for being the first line of support on an enterprise operations
desk, including: answering phone calls from end-users, utilizing a
ticketing application to route email requests to specialized technical
support teams, resolving tickets for users over the phone relating to
Active Directory account creation/maintenance, supporting end-users with
specialized and COTS applications in accordance with SLA, and some
statistical reporting on ticket arrivals, backlogs, etc. Ensure accuracy,
completeness, and consistency of deliverables with contractual
requirements. Interface with, and support, other MIP Help departments in
researching contract requirements. Responsible for second level phone and
desk side break fix support, software installs, new customer setups,
customer training Responsible for troubleshooting, and restoring network
connectivity for e-mail, printers, desktop workstations, laptops, and other
IT infrastructure components is always operational and performing to meet
performance requirements.
Be cognizant of a specific region's network and subsystems
Monitor performance and troubleshoot as required.
Update system documentation, facilitate on-site troubleshooting, and
provide limited system training to users
Able to coordinate multiple activities simultaneously and respond
effectively to a wide range of business technology needs.
Hands-on experience with Support Wizard and Enterprise Wizard.
Experience providing excellent customer/client service
TPA Works
Fairfax, VA
Claims Analyst/Customer Service Supervisor
2006 to 2008
Entered data from HCFA 1500 and UB-92 to process medical claims.
Investigated claims for subrogation and pre-existing conditions.
Responsible for developing and maintaining relationships with physician and
business leadership of key physician groups and ancillary providers
Provides provider relations and services support (network and non-network
providers) for assigned geographic area(s); conduct provider group seminars
and training sessions
Received escalated inbound calls from incensed providers and policyholders
regarding claim status and benefit schedules
Developed and maintained a highly-functioning training manual
Created a call reporting system to assist in call filtering which assisted
in the implementation of an automated call routing system
The Scott Bower Group
Jackson, MS
Initial Intake Adjuster/Claims Adjuster
March 2000 to April 2006
Reviewed police reports, medical treatment records,
medical bills, or physical damage to determine the extent of liability.
Examine claims forms and other records to determine insurance coverage.
Interviewed or corresponded with claimants, witnesses, police, physicians,
and other relevant parties to determine claim settlement, denial, or
review.
Prepared report of findings of investigation.
Interviewed or corresponded with agents and claimants to correct errors or
omissions to investigate questionable claims.
Analyzed information gathered by investigation, and reported findings and
recommendations.
Referred questionable claims to investigator for investigation or
settlement.
Negotiated claim settlements and recommended litigation when settlement
could not be negotiated.
Collected evidence to support contested claims in court.
In 2004, became Licensed Agent/Customer Service representative who issued
quotes to potential customers and wrote and issued policies to those
seeking coverage for their, home, car or rental. Ensured financial and
administrative filing systems remained up to date. Worked with MetLife Auto
& Home, Safeco, State Auto and Safeway
Answer inbound calls from independent agents and policyholders. Explain
billing, policy changes, and CLUE and MVR findings
Processed endorsements via phone fax and email.
Determined customers' eligibility to qualify for certain discounts and
programs
Provided support to underwriting by making application and rating decisions
that would affect the policyholders tier, premiums and standard vs. non-
standard market placement
Allstate Insurance Company
Jackson, MS
Claims Adjuster
1999 to 2000 Provided
AUTO/CASUALTY claims service via internal channels
(phone/email/fax/mail/other electronic channels) to members and third-party
customers. Adjusted moderately complex auto claims. Severity of claims
includes soft tissue losses involving neck injury, back injury, and PIP/Med
Pay. Acquired and applies intermediate knowledge of P&C insurance industry
products, services, and processes to include P&C insurance policy contracts
and coverage's, claim handling process and procedures. Collaborated with
team members to resolve issues and to identify appropriate issues for
escalation. Partnered and/or directs vendors and internal business partners
to facilitate claims resolution.
Contributes to business goals, performance metrics and effectively uses
tools & technology.
Blue Cross Blue Shield of Mississippi
Jackson, MS
Claims Processor/Adjudicator
1997 to 1998
Entered data from HCFA 1500 and UB-92 to process medical claims. After
initial intake, investigated claims for subrogation and determined if claim
qualified for payment or rejection. Consistently met and subsequently
exceeded production goals. - Identified opportunities for process
improvement and worked cross-functionally within the organization to gain
desired outcomes regarding provider service issues
Education
Hinds College
Jackson State University
Psychology
70 credit hours earned
Information Technology Skills
WordPerfect, Word, Excel, Access, Quickbooks, PowerPoint, Internet,
Microsoft 2000, Windows 2000 and similar applications. Windows
2007/XP/2000/NT/98/95, DOS, TCP/IP, UNIX, SQL Demonstrated knowledge of
managed care industry and provider relations activities
10+ years related experience Collaboration experience across multiple
functional areas. Working knowledge of provider business operations
Strong communication, critical thinking, interpersonal and negotiation
skills
CompTia Network+ 2009, Systems Analysis and Design, Database Fundamentals,
Network Security Basics
Responsible for the creation of the Tier I & II Standard Operating and
Procedure manual.
Contact this candidate