Customer Service Representative

Karen D. O’Reilly

*** ******** ****

Stone Mountain GA 30083

Cell: 678-***-****

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

OBJECTIVE: To obtain long- term employment with a company that allows me to utilize my skills, while allowing room for Professional, Educational, and Technical growth.

QUALIFICATIONS: An extensive background in working inside a team environment while maintaining a personal drive for quality, efficiency and accuracy. History of longstanding employment within an organization allowing for a variety of experiences, challenges and growth opportunities.

EDUCATION:

1998-1999 Medix School; Medical Insurance Coding and Billing

1988-1998 Waterson Skill Center; Business Administration

EMPLOYMENT:

2007-2014 Escalation Analyst; Aon Integramark

oUnderstand the client service level agreements as it relates to the escalation process

oMonitor escalations through daily review of the escalation process management

database (EPM) reporting, client reporting, and AIM system updates

oDetermine appropriate route of customer resolution based on customer communication, AIM systems information, and AIM processing guidelines.

oCustomer Calls: Focus on data provided by the customer, status update information and data required for processing customer request.

Facilitate assistance throughout AIM, as needed, to resolve customer escalations.

oResearch and process executive level or customer complaints within 4 hours.

oIdentify call center customer service representative issues in the EPM database.

oIdentify unusual processing trends, document specific examples for reference and communicate the results of your research.

2006-2007 Administrative Support; Manpower

oHandle all confidential incoming fax from all clients.

oCoordinate delivery of large projects within multiple departments

oFacilitated filing and mail to all company departments.

oSuggested new mail code system, which reduce filing errors and increased timely delivery.

1999-2006 Sr. Claims Specialist; Blue Cross Blue Shield

oConduct research, resolve issues,review for errors and inconsistencies in a variety of claims

oAssist in coordination of department projects and special assignments.

oReceive and place follow-up phone calls/email to answer customer inquiries regarding company services, products, insurance, benefits, provider contracts and claims.

oDuties include Transplant, DME, Outpatient and Inpatient Pac.

oAssist peers to ensure efficient department workflow within a team environment.

1998-1999 Front and Back office Support; Meridian Medical Group

oHandle large volume of calls in regards to patient scheduling, referrals, cancellations and education of referral procedures.

oAccurately maintained correspondence log in accordance with procedural guidelines in terms of requests and release of confidential patient information.

1996-1998 Unit Secretary; Emory Children’s Center

oMaintain all back office functions in regards to calls, messages, and appropriate distribution of incoming correspondence.

oAccurately maintain physician’s schedules

oReview and process transcription letters for all physicians

1989-1996 Active Record Unit Lead; Atlanta Medical Associates

oMaintain full knowledge of all active records process to include proper tracking.

oPerform quality assurance monitoring to ensure that the clerks are performing duties according to policies and procedures.

oPerform insurance verification, billing and coding.

oUpdate patient insurance and other confidential information into computer database

oOrganize and complete daily financial reports.

* References available upon request

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