Customer Service Representative

Radie C. Peterson

***** ********** **., **** ****

Farmington Hills, MI 48334

Email : ************@***.***

Phone: 248-***-****

OBJECTIVE

My goal is to secure a business development position leveraging strong leadership, customer service and

relationship building skills while utilizing over 37 years of business and health insurance experience.

PROFESSIONAL SUMMARY

• Over 10 years of extensive health care industry experience

• Extensive Medical Benefits and claims knowledge

• Detailed training and knowledge in NASCO

• Other skills include: Blue Cross Blue Shield Benefit Training, Medicare Parts A, B, &C, Dental,

Vision, and Hearing, Major and Master Medical, CRT Displays, Word Processing, TSST

Processing, Professional and Facility Benefits, Membership/Eligibility, SMART, Blue Connect.

HIPAA

• Skilled in Microsoft Word Excel, Outlook, MC Access, and Power Point/Share Point

• Warm friendly and courteous customer service abilities

• Detail oriented with excellent interpersonal skills

PROFESSIONAL EXPERIENCE

Sylmara E. Chatman, MD January, 2013 to September 13, 2013

Receptionist

• Interact and greet patients

• Verify insurance

• Schedule appointments

• Pulling Charts

• Answering phone calls and assisting other personnel

Swanson Funeral Home October, 2009 to May, 2010

Receptionist

Interact with residents, guest, and visitors in a friendly, courteous, and professionally

The Heatherwood Retirement Community September, 2008 to October, 2009

Receptionist

• Interact with residents, members of the staff and greet visitors in a friendly and courteous manner.

• Sort incoming/outgoing mail and correspondence

Answer telephones

Blue Cross Blue Shield of Michigan October, 1969 to July, 2007

Unit Leader, Group Review Analyst, Customer Service Representative, Secretary, and Typist

• Prepared weekly and monthly reports, assign work to analysts.

• Initiated and redirected inquiries to Customer Service Representative for subsequent resolution

where direct intervention is required.

• Interacted directly with Marketing Account Managers and Benefit Analysts as well as System

Analysts to clarify and discuss the intent of group structures, benefit changes and eligibility

matters.

• Ensured customers’ needs and expectations were met and facilitated improved servicing and

customer satisfaction by interfacing with multiple BCBSM operation areas and our partner BCBS

plans.

• Provided quality customer service by responding to telephone calls, faxes, emails and attending

internal meetings.

• Conducted special assignments as requested, documenting results with recommendations to

management.

• Assisted personnel (both internal and external) with benefit issues/concerns.

• Supported new business workgroup implementation, lead and/or support special projects to

produce desired results, identify/analyze business problems and develop business cases for

solutions, represent the department/division on work groups.

• Developed and improve workflow and business processes to improve customer servicing and

decrease operational costs.

• Assisted in improving the quality and timeliness of the departmental responses in an effort to

meet Performance Guarantees.

EDUCATION

Central High School Diploma

Some College: University of Detroit Mercy and Lansing Community College

AWARDS

Blue Cross Blue Shield of Michigan Pride in Excellent –Multiple received for quality and production

Wayne State University Joint Leadership Certification for United Auto Workers and Blue Cross Blue

Shield of Michigan

Contact this candidate