Customer Service Representative
Resume:
Darlene West
**** **** ***** ***** – Apt. *
Charlotte, NC 28217
acxo20@r.postjobfree.com
OBJECTIVE To obtain a customer service position within an organization that can benefit from my initiative, capabilities, and contributions while gaining knowledge and experience.
EDUCATION Brookstone College of Business Charlotte, NC
Information Processing Technology 2004
Essex College of Business Newark, NJ
Secretarial Word Processing 1986
SKILLS Proficient in Microsoft Office Suite. Ability to multi-task within several software applications. Excellent verbal and written communication skills. Typing speed of 70+ wpm and data entry speed 10,000 kpm.
EXPERIENCE West Med Medical Group Charlotte, NC
Contact Center Associate February 2016 – September 2016
Answered high volume inbound calls in a professional manner. Registered and updated patients profile, scheduled, cancelled and rescheduled appointments (via Centricity) for various specialties after three point verification of the caller and informed patient/caller of any instructions they need to follow prior to appointment. Sent messages via Centricity to providers, physician assistants, nurse practitioners and/or office staff regarding Rx refill requests, lab/test results, and general messaging to provider’s offices (sooner appointments and general call back requests). Placed outbound calls to patients regarding various follow-ups. Submitted referrals and assisted with the bump list. Reached out to provider’s offices regarding emergency situations via the emergency back line.
Xerox Charlotte, NC
Customer Service Representative October 2015 – February 2016
Answered high volume inbound calls in a professional manner to Independence Blue Cross members. Educated members on their benefit information regarding their deductible, co-pay, co-insurance and out of pocket maximum for a particular procedure to be performed in an inpatient/outpatient setting, whether or not a medical procedure is covered under their health plan, prescription co-payments as well as assistance with initiating prior authorizations for a procedure(s). Researched and provided information to members as to why a claim was denied and how to correct a claim and resubmit for payment. Processed monthly premium payments. Updated member’s primary care physician. Assisted members in the process of filing an appeal/grievance. Educated members on how to apply to various agencies for additional assistance with co-payments and/or prescription drug coverage. Updated member’s account in regards to telephone number and address changes. Mailed out various forms (i.e. HIPAA authorizations, enrollment packages, prescription formulary, and providers directory) to members mailing address on file.
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Darlene West
acxo20@r.postjobfree.com
Lash Group Charlotte, NC
Benefit Verification Specialist July 2012 – October 2013
Verified insurance coverage for drug Prolia by filling out insurance verification forms, calling various payers and pharmacy vendors to obtain patients cost share based on their plan coverage for injections. Entered information into database and faxed results to the fax queue for accuracy before faxing results to the ordering physician’s office. Processed the re-verification list. Assisted sub-team by making sure patient information is entered into database correctly and record is ready to be processed for patient assistance program.
Patient Case Coordinator November 2011 – July 2012
Made outbound calls to patients to educate them on their cost share for the drug Prolia. Called physicians offices to obtain missing information needed to complete insurance verification requests. Received inbound calls from providers’ offices and patients. Verified that the patient information entered into database is accurate. Assisted site coordinators with their task list by processing re-verification lists.
Aerotek (Lash Group/Temp) Charlotte, NC
Customer Service Representative August 2010 – November 2011
Process Synagis referrals by pulling referrals from the missing information queue, checking them for accuracy against documents sent in by physician offices and/or specialty pharmacies. Called physician offices in the efforts of obtaining missing information via fax and phone. Received and verified missing information, updated patients’ record in the MedImmune database and sent referrals and supporting documents to the specialty pharmacy. Trained 1st seasonal associates. Liaison for MI team.
SMX Staffing (Temp) Charlotte, NC
Assistant to Supervisor October 2009 - April 2010
Checked employees in at start of shift. Ensured employees were following safety protocol and observed their productivity. Filled out appropriate forms for accidents, complaints, and employees with attendance issues. Input ticklers via PC for employees attendance, terminations, layoffs, and re-hiring status.
Packer (Temp) March 2009 – October 2009
Packed merchandise for shipment to vendors. Built displays for packed merchandise to be shipped.
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Darlene West
acxo20@r.postjobfree.com
Sprint Charlotte, NC
Jr. Agent December 2005 – September 2008
Answered inbound calls for Sprint customers (approximately 10-15 per hour). Processed cell phone payments. Offered customers various upgrades, based on their cell phone usage. Applied necessary adjustments to customers account if needed. Verified detailed bills and account information with customer. Routed calls to appropriate department within Sprint based on customer concerns. Changed and updated customers billing information. Logged all payments made on accounts.
References available upon request
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