EBONY C. TIMS

210-***-****

San Antonio, TX *****

ad0my3@r.postjobfree.com

EDUCATION

ASSOCIATES of BUSINESS DEGREE

St. Philips College

US ARMY

HIGH SCHOOL DIPLOMA

AC Jones High School

PROFESSIONAL PROFILE

Proactive, self-motivated healthcare worker with 11 years of medical and insurance experience, seeking a healthcare position that will allow me to fully utilize my communication, organizational, and problemsolving skills as well as having the opportunity to expand my knowledge in new areas.

EXPERIENCE

PHARMACY HELP DESK ASSOCIATE

Continuum Global (Sept 2022-current)

Answer Inbound Calls from Customers and Address Questions & Concerns

Provide information about member pharmacy coverage & benefits

Make outbound calls to customers, Insurance and/or Doctor's office as needed to verify eligibility

Resolve concerns to simplify member healthcare experience

Navigate through multiple computer applications with speed & accuracy

Ability to adjust schedule as needed when volume of work business needs change

SALES REPRESENTATIVE

All School Fundraising / San Antonio, TX / Jan 2014 – March 2015

Outbound calls to companies to offer advertising on various items given out at school events to all schools to gain funds for various projects.

Outbound calls to businesses and private individuals to solicit sales for goods and services, and to request donations for charitable causes.

Provide explanation of products and services. Provide prices of products, and answer questions from customers.

Data entry of orders for fulfillment to customers

CUSTOMER SERVICE REPRESENTATIVE

Calling Solutions / San Antonio, TX / Sept 2005 – Oct 2007

Resolve customers' service and billing complaints by performing activities such as exchanging merchandise, refunding money, and adjusting bills.

Complete contract forms, prepared change of address records, and issue service discontinuance orders, using computers.

Contact customers to respond to inquiries and to notify them of claim investigation results or any planned adjustments.

Solicit sales of new and additional services and products.

Order tests that could determine the causes of product malfunctions.

Provide ongoing analyses in areas such as transportation costs, parts procurement, back orders, and delivery processes.

Prepare reports on logistics performance measures. -Conferred with logistics management teams to determine ways to optimize service levels, maintain supply chain efficiency, and minimize cost.

Remotely monitor the flow of vehicles and inventory, using Web-based logistics information systems to track vehicles and containers.Business contractual requirements and guidelines to include timely data entry in MSR.

Complete and document in MSR accurate and timely determinations of appropriateness of level of care: take appropriate actions to facilitate direction of patients to correct level of care as indicated by criteria

Knowledge of the various coding system: ICD-9, CPT and HCPCS codes.

Receive document and resolve customer inquiries by using established best practices.

Educate customers, providers and employers about Humana's products and services over the telephone.

KEY SKILLS

Medical Terminology

Microsoft Word, Outlook and PowerPoint

Client Relations/Customer Service

Relationship Building

Detail Oriented

Results Driven

Insurance Verification & Authorizations

Time Management

Adaptability

Data Entry

50+ WPM

REFERENCES

REFERENCES AND LETTERS PROVIDED UPON REQUEST

EXPERIENCE CONT.

AUTOMATED LOGISTIC SPECIALIST

US Army / Sept 2005 – Oct 2007

Maintain databases of logistics information.

Interpret data on logistics elements, such as availability, maintainability, reliability, supply chain management, strategic sourcing and distribution, supplier management, and transportation.

Provide ongoing analyses in areas such as transportation costs, parts procurement, back orders, and delivery processes.

Prepare reports on logistics performance measures. -Conferred with logistics management teams to determine ways to optimize service levels, maintain supply chain efficiency, and minimize cost.

Remotely monitor the flow of vehicles and inventory, using Web-based logistics information systems to track vehicles and containers.

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