Customer Service Representative

Sparkle Simmons

*** ******* ***** ~ Jonesboro, GA 30236

678-***-**** **************@*****.***

OBJECTIVE

Seeking a challenging position as a Business Analyst in either the Healthcare field and or information technology, which will allow me to further utilize my skills and acquire new abilities.

SUMMARY OF QUALIFICATIONS

Strong analytical and organizational skills

Proficient in Microsoft Word, Excel, Outlook and Internet research

Effectively multi-tasks and adapts to fast-paced situations to maximize efficiency

Works well independently or as a team member

Demonstrates high degree of integrity and discretion

Possesses a commitment to quality customer service

PROFESSIONAL EXPERIENCE

GEORGIA DEPARTMENT OF COMMUNITY HEALTH

State Health Benefit IT

Business Analyst-Feb 2014-Presently

Define and implement new process or modify existing process and procedures that impacts both business unit and IT.

Analyzes the business objective of the stakeholder and develops solutions to their business issues.

Develop Customer Service Request and participate in any business processes.

Manage any change requests related to the working project plans daily to meet the agreed deadlines.

Aids programmers in developing their business goals and objectives for projects and Customer service Request for the health coverage.

Represents business units in board meetings and possess the ability to fully translate decisions made to business.

Serve as interface between SHBP IT, policy, and the vendors.

Consults with vendors or technical staff to insure that functionality of automated systems is consistent with adherence to laws, regulations, and best practice standards by users.

Translate business requirements to System/Functional requirements in preparation for submission to application developers.

Provide expertise in the business unit processes they support and systems components associated with these processes.

Ability to identify systems defects and serves as key point of contact for troubleshooting and resolution.

Serve as lead in evaluation of new technologies or solutions to improve service and efficiency of systems.

Develop test plans, test cases, and associated test data needed to execute User Acceptance Testing.

Identify, analyze, and documents business requirements and delivers work products throughout the project life cycle.

State Health Benefit Plan

Customer Service Representative-June 2012-Jan 2014

Answers questions, distributes literature, and provides interpretation services for visitors

Assists customers, applicants, visitors, personnel and officials regarding regulations, policies and procedures

Complies information and statistics needed

Develops, displays and maintains information and literature for assigned area or site

Generates written responses to customer inquiries, update databases, enters data

Responds to customer inquiries from telephone calls, emails, and/or faxes

Retrieves computer records and enters or updates databases

May gather information for and initiate procurement documents, verify receipt of goods and services,

Division of Medicaid/Member Merge Policy Unit

Medicaid Research Clerk-Nov2010-May2012

Conducts specialized research of various databases including Gammis,SUCCESS,SDX and SXC to determine eligibility status

Performs eligibility updates in MEMS and SXC systems

Serves as a communication link between assigned unit and program.

Processes and/or review applications

Maintains appropriate eligibility policies and procedures.

Initiates actions to acquire necessary information for eligibility status

Interprets and applies relevant policy and procedure revisions

Assists with other program areas and agencies on Special Projects(Member Merge and Interstate Paris Match)

Atlanta Peach Movers, Atlanta GA

Customer Service Coordinator-March2007-2009

Create and maintain records of plans, insertion orders, schedules and contracts.

Complete moving arrangements, process expense reports, and track budget in company database.

Confirm the accuracy of all vendor contracts.

Manage confirmation of all orders and resolve discrepancies.

Perform general office functions, interact with company members and support executive staff.

Rolle Brothers Moving Company, Miami FL

Administrative Assistant-Dec2005-2007

Supported upper management, three account representatives, and moving staff.

Coordinated logistics for meetings, orientations, and training classes for employees.

Generated payroll checks and maintained accounts payable records.

Prepared and administered daily assignments to respective staff members.

Processed daily expense reports to be tabulated into a database.

Nations Health, Sunrise, FL

Trainer-Oct2004-2005

Conducted in-house practical training for staff development and client/company relations to ensure quality assurance.

Train group of 8 or more on the product and how it works.

Customer Service Representative-2003-2004

EDUCATION

Strayer University

Business Administration 2011- Presently

Major: Bachelor of Business Administration Concentration in Health Service Administration

COMPUTER SKILLS

Proficient in Microsoft Word, Excel, Internet research, and typing 55 wpm.

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