Customer Service Representative
Resume:
Sameshia A. Ford
Arlington, TX 76017
(601) 813- 1967
*********@*****.***
Objective: To obtain a position where I can utilize and maximize my leadership, customer
service skills and experience in a growing organization.
Employment: The University of Mississippi Medical Center August 2013- Current
Patient Financial Service Representative
Reviews, monitors, and obtains reimbursement information from insurance companies
Communicates with Medicaid, Medicare, and other Third Party payers to facilitate
insurance verification and claims processing
Reconciles Medicaid, Medicare, and other Third Party payers to ensure an accurate
accounts receivables and prepares weekly/monthly reports as needed
Monitors and ensures timely and efficient submissions to insurance of financial
eligibility documents
Responsible for confirming eligibility of insured and determining payment criteria
Copying, faxing, and all other general office duties assigned by supervisor
Completes, submits, and obtains authorizations for all payers
Accurately performs data entry and related documentation input activities within 24 hours
of receipt
Accurately enter client registration and billing data into the billing system
Research and generate reports as directed
Completes special projects and other assignments as instructed
Meet designated productivity and/or quality measures for assigned job task
Broadpath Solutions- Arkansas BCBS June 2013- August 2014
Customer Service Representative (Work from home)
Handled customers inquiries about the Affordable Care Act
Answer questions about plan benefits
Use estimator tool to suggest and discuss a more affordable health plan
Respond to fast pace inbound calls in a at home setting
Provide superior customer service and work quality while demonstrating attention to detail
Use applicable facts and data to detect and solve a range of problems within area of expertise
Universal Healthcare Group September 2011- March 2013
Member Service Representative I
Handle customer inquiries, complaints, benefit, and claims questions about insurance plans
and policies. Maintain a high call volume workload and within a driven call center environment.
Successfully diffused customers during escalated situations.
Viewed as an exceptional Team player.
Resolve and assist in multiple calls in a given week. Consistently meeting my performance
bench marks in all areas (quality, adherence, wrap, talk and hold).
Perform and respond to inbound service calls in a fast paced, high- volume call center.
Provided superior customer service and work quality while demonstrating attention to detail,
flexibility and innovation in resolving problems.
Possess effective communications skills, and work well with others at all levels.
Assist providers with multiple Medicare and Medicaid claims, benefits, and escalated issues.
worked in an organized managed care environment.
File grievance and appeals for Medicare and Medicaid providers and members.
Probe non-standard desires and problems, with minor assistance from others.
Use applicable facts and data to detect and solve a range of problems within area of expertise.
Jackson Public School Transportation North August 2009- 2011
Transporter
Respond to parents regarding status of bus routes and times of pick- up and drop off times
Manage bus maintenance, mileage, boarding passengers
Resolving issues with students, parents, and school officials issues through office personnel
ultimately achieving a positive outcome
Accountable for problem resolution of student/parent issues and to communicate resolution to
appropriate parties.
Northtown Child Development Center August 2006- 2009
Office Manager and Clerk
Consulted with customers to ensure positive childcare and learning experience
provided customers with a positive service experience.
handled business transactions in connection with payments and create new customer accounts
on a terminal.
Communicated with MS grant personnel using web-based tools and demonstrated the
associated proficiency in typing and grammar while working with grants.
Perform data entry, as needed for parents, directors, and employees
Answered phone calls and directed inquiries as appropriate
File, fax, and deliver information in reference to a Grant funded through the State of
Mississippi and childcare facility.
Education: Holmes Community College- Ridgeland, MS
24+ credit hours in Biology, July 2007
Jackson State University- Jackson, MS
BS in Professional Interdisciplinary Studies, May 2013
Grantham University- Lenexa, KS
Master of Healthcare Administration, April 2014- current
Volunteer Activities: Baptist Adult Daycare, Old Canton Rd., Jackson, MS
Help assist with recreational activities for dementia and Alzheimer patients, Stew Pot, Northtown
FFRC, Northtown CDC Teen/Girls Group
Skills: Microsoft Word, Microsoft Office, Excel, Power Point, Faxing, Financing Scheduling,
Sales, Management, Organizing, Fortuna, OneNote, RoboHelp, MMIS, Customer Service, Five 9
Call System, Claims, Checking Authorizations, Verifying Healthcare Insurance
Contact this candidate