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Customer Service Health Plan

Location:
Decatur, GA
Salary:
$21.00
Posted:
October 22, 2023

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Resume:

SHEQUIRA A. LOFTIN

ad0jo9@r.postjobfree.com • 770-***-**** • TUCKER, GA

SUMMARY OF RELATIVE SKILLS

•Proficient with following software and systems: Microsoft Office (Outlook, Excel, PowerPoint)

•Outstanding customer service, problem-solving, listening, written and oral communication skills.

•Experience in entering, auditing, and monitoring data

•Able to focus on projects, develop strategies and meet or exceed deadlines

•Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or different approaches to problems.

•Identifying complex problems and reviewing related information to develop and evaluate options and implement a solution.

EDUCATION

General Education Diploma

Personal Care Assistant Certificate

EXPERIENCE

Rose INTL-Kaiser Permanente Customer Service I

Duluth, GA May 2023-Current

•Represent Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.

•Respond professionally to inquiries from internal/external customers.

•Assist customer by processing monthly billing premiums.

•Answer incoming calls about health services, co-pays and appointments.

•Promote, ensure, and provide customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.

•Ability to understand relevant policies, processes, and customers.

•Assist the department in meeting customer needs and reaching department expectations.

•Completes required training and understand how to use tools available to recall necessary information.

State Farm Care Center Specialist II - Retention 2

Dunwoody, GA June 2022-September 2022

• Committed to solving customer needs on the first contact through simple, high-quality, and

personalized experiences

• Focused on retaining existing customers while working in a high call volume. assisting with

variety of needs such as making payments, providing proof of insurance, password reset.

• Assisted customers with policy changes to coverage/deductibles

• Analyzed customer feedback, negotiated with customers, implemented retention strategy, and compiled reports for sales managers

• Checked to ensure that appropriate changes were made to resolve customers' problems.

• Conferred with customers by telephone to provide information about services.

• Resolved billing complaints by refunding money, adjusting billing, changing plan and or posting late payments.

E-Health Inc Sales Support Representative

Santa Clara, CA June 2021-April 2022

• Followed HIPPA compliance guidelines

• Collected, verify, enter, and maintain data and medical record information including but not limited to patient, provider, and payer contact and referral information.

• Transferred calls to designated department when warranted

• Understand, and follow company guidelines, policies, and department procedures.

• Verified all insurance information for the caller to stay complaint

• Made sure that caller qualified for extra benefits based on the type of insurance they have

• Responded to customer questions via telephone and written correspondence regarding

insurance benefits

• Researched state benefits for the member and assign member to the correct department

• Thoroughly documented inquiry outcomes for accurate tracking and analysis

Corporate Payroll Services (CPS) Norcross, GA

Inside Sales Rep/Appt Scheduler January 2019-December 2019

• Called business owners to set up appointments for Outside Sales Reps to meet with then and

sell our services.

• Communicated our payroll services and payroll tax services to business owners

• Provided excellent customer service and sales support via phone and email

• Emphasized or recommend service features based on knowledge of customers' needs and vendor capabilities and limitations.

• Consulted with clients after sales or contract signings to resolve problems and provide ongoing support.

•Maintained customer records using automated systems.

Cue Barbecue Norcross, GA

Food Server 2016-May 2023

• Delivered friendly and professional customer service to restaurant patrons.

• Ran food to tables in a timely manner, making sure that guest receive their food with all the

specific modifications 100% of the time

• Processed phone and online orders

• Delivered checks and collect cash and credit card payments

• Followed all relevant health department rules/regulations and all customer service guidelines

• Assisted in training of new servers, ensuring attention to detail and comprehensive

understanding of restaurant methodology and practice

Hope in Home Care Virginia Beach, VA

Personal Care Assistant 2015-2016

• Cared for individuals or families during periods of incapacitation, family disruption, or convalescence, providing companionship, personal care, or help in adjusting to new lifestyles.

• Prepared and maintain records of client progress and services performed, reporting changes in client condition to manager or supervisor.

• Accompanied clients to doctors' offices or on other trips outside the home, providing transportation, assistance, and companionship.

• Assisted with medication and food preparation

• Recorded and reported changes in clients’ status.

Elite Home Healthcare Chesapeake, VA

Personal Care Assistant 2013-2014

• Planned, shop for, or prepared nutritious meals or assist families in planning, shopping for, or preparing nutritious meals.

• Ensured clients vital signs are completed and documented accurately

• Assisted with all activities of daily living

• Transported clients to locations outside the home, such as to physicians' offices or on outings, using a motor vehicle

Applebee’s Duluth, GA

Waitress 2007-2012

• Described menu items, daily specials in detail and provided recommendations when requested.

• Relayed the various ingredients and cooking methods.

• Checked patrons' identification to ensure that they meet minimum age requirements for consumption of alcoholic beverages.

• Collect payments from customers.

• Write patrons' food orders on order slips, memorize orders, or enter orders into computers for transmittal to kitchen staff.



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