Customer Service

Bonita Campbell

**** ******** ** ********** ** **006

972-***-**** ********@*****.***

Professional Objective

A result driven professional with 10 + years of management, call center experience including health insurance, Medicare, Medicaid, medical claims processing, medical collections, leadership and experience in a high -volume environment.

Professional Experience

Travel Agent (Work at Home) March 2020 - Present

Teleperformance American Express

Answer inbound calls in a remote environment assisting American Express card holders with booking travel arrangements for flight, hotel and car reservations.

Continuously use active listening skills to collect relevant information to anticipate customers needs to up sell travel and ensure accommodation are provided.

Building a rapport with customer while handling objectives such as flight cancellations, airline seats and hotel room upgrades to identify custom solutions in our commitment to maintain a first point of contact resolution.

Continuously demonstrated organization skills with the ability to multitask to search and navigate through multiple windows and screens quickly and inputting information accurately while keeping pace with the call.

Follow the company compliance and privacy regulations while taking payment and collecting fees.

Educate card holders with the appropriate documentation needed to travel such as passports visa, and government issued identification needed to travel to their destination.

Meet performance goals including customer service survey, sales, and quality, adherence and attendance.

Provider Service Representative (Work at Home) October 2019 -January 2020

Blue Cross Blue Shield of Arizona/Broad-Path Tucson AZ

Answered an average of 50 incoming calls from providers in a remote environment.

Handled and resolved inbound calls to verified benefits, claim status, and review claims accuracy.

Resolved claim issues including appealing denied claim and submitting for adjustment when needed, verify procedure codes to determine if precertification is required.

Assisted providers to navigate thru the Blue Cross Blue Shield of Arizona website for self-service, including requesting precertification and explanation of benefits.

Maintain confidentiality and project a professional business image.

Documented every call from providers complying with HIPAA regulations and guidelines

Resolved problems quickly and ensure situations did not escalate while maintained a monthly quality score of 98 %.

Provided superb customer service to achieve while maintaining 98% schedule adherence.

Travel Agent (Work at Home) April 2019 – September 2019

Teleperformance American Express

Answer inbound calls in a remote environment assisting American Express card holders with booking travel arrangements for flight, hotel and car reservations.

Continuously use active listening skills to collect relevant information to anticipate customers needs to up sell travel and ensure accommodation are provided.

Building a rapport with customer while handling objectives such as flight cancellations, airline seats and hotel room upgrades to identify custom solutions in our commitment to maintain a first point of contact resolution.

Continuously demonstrated organization skills with the ability to multitask to search and navigate through multiple windows and screens quickly and inputting information accurately while keeping pace with the call.

Follow the company compliance and privacy regulations while taking payment and collecting fees.

Educate card holders with the appropriate documentation needed to travel such as passports visa, and government issued identification needed to travel to their destination.

Meet performance goals including customer service survey, sales, and quality, adherence and attendance.

Customer Service Representative (Work at Home) August 2018 – January 2019

Blue Cross Blue Shield of Kansas/Broad-Path Topeka KS

Answered an average of 50 incoming calls from members and providers in a remote environment.

Handled and resolved inbound calls for Medicare Plan 65 and Voluntary Dental policies.

Verified benefits, claim status, billing questions, policy changes, and terminating policy at member request.

Documented every call from members and providers complying with HIPAA regulations and guidelines.

Processed premium payments, submitted reinstatements of terminated policies on behalf of the member and responded to customer service inquiries within established turn- around time.

Resolved claim issues including appealing denied claim and submitting for adjustment when needed, processing refunds and stop payment of checks.

Assisted members to navigate thru the Blue Cross Blue Shield of Kansas website for self-service, including making changes to their policy and locating network and non- network providers.

Resolved problems quickly and ensure situations did not escalate while maintained a monthly quality score of 98 %.

Provided superb customer service to achieve 100% Customer Service Satisfaction surveys monthly while maintaining 98% schedule adherence.

Team Lead

Cardinal Health, Lewisville TX May 2015 – May 2017

Monitored the day to day activities of work queues and inbounds calls to ensure service levels were met.

Inspired employees to maintain peak performance and productivity levels while simultaneously maintaining high employee moral across the board.

Handled and resolved inbound escalated calls when the need arises.

Ran daily reports to assist with department production goals.

Trained, answered questions, conducted quality reviews and audits of all coordinators pertaining to the Makena book of business.

Assisted with creating policies and procedures and immediately communicated changes to the team. s.

Working knowledge of all systems for maximum efficiencies and monitoring workflow.

Conducted annual performance reviews, evaluated staff performance for merit increases, promotions, disciplinary actions and maintained appropriate personnel documentation.

Case Manager October 2015 to May 2016

Cardinal Health, Lewisville TX

Compiled insurance verification of benefit summary and eligibility information submitted by the patient for processing of Patient Assistance Program.

Ensure verification of Medicare, Medicare Part D, Medicaid, and Commercial insurance eligibility information obtained from payer/insurance company was accurate via Medicare.gov, Emdeon, Guardian and payer’s commercial site.

Documentation of all communication with patients as well as Health Care Providers in electronic HIPAA compliant application to determine program eligibility.

Processed urgent re-enrollment cases to ensure patient’s therapy was not interrupted.

Open line of communication with Health Care Providers to obtain necessary documents needed to complete Prior Authorization for Benefit Investigation Summary.

Contacted patients to explain program and Welcome call.

Call Center Team Lead August 2015- October 2015

CMI Group, Carrollton TX

Supervised daily operations of 20 Customer Service collection agents.

Oversee the representatives taking inbound calls, collecting payments on past due accounts and set up payment arrangements.

Monitored and tracked time and attendance as well as live and recorded calls to ensure quality standards were met.

Conducted weekly one on one’s and coached to low performers.

Measure reports and communicate service level goal attainment on a daily, weekly and monthly basis for team members.

Call Center Retention Supervisor February 2015 – June 2015

Torchmark Corporation McKinney TX

Supervised daily operations of 10 Customer Service Retention representatives.

Coaching to use various sales techniques to help increase the retention of policy holders.

Managed the representatives making outbound calls to existing policyholders to collect delinquent premium payments, resell the benefit of the policies and provide excellent customer service.

Monitor recorded calls as well as side by side to ensure the quality standards were met and ensure representatives were meeting production standards of 22 calls per hour.

Conducted interviews for new hires, orientation and performance management.

Measured reports and communicated service level goal attainment to management on a daily, weekly, and monthly basis for individuals, teams and the call center overall.

Customer Service Supervisor May 2010 – February 2014

Pro Path Services, Dallas TX

Supervised a team of 4 employees and a Client Service Representative

Managed the call center operations to ensure the staff achieved performance, quality and efficiency goals through effective monitoring, coaching training and performance management.

Created standards for quality and timeliness performance audits.

Reviewed subordinate adherence to daily schedules in order to meet customers' expectations, and service level accessibility.

Training, assigning work, scheduling time off, counseling, and disciplining employees.

Monitoring insurance claims queue to identifying coding or billing problems from the Explanation of Benefits to correct errors in a timely manner.

Monitored client’s account receivable, aging, denial management, and refunds.

Functioned as a liaison between leadership, staff and client management regarding billing and collection issues.

Operations Supervisor November 2008 – April 2011

Coventry Health Care Worker’s Compensation, Dallas TX

Supervise a team of 15 employees and Team Lead.

Ensured staff achieved performance, quality and efficiency goals through effective monitoring, coaching, training and performance management for Workers Compensation Claims, and Utilization Review.

Assisted with directing workflow and managing turnaround times for benefit coverage review and clinical appeals.

Provided guidance to staff in resolution of difficult questions to ensure accurate claims processing.

Conduct monthly feedback and informal mid-year performance reviews; assist in the hiring process.

Build relationship with payers, employers, providers, and Management team members.

Relevant Skills

Typing Speed: 45 wpm

Expert in the use of Avaya phone system, CCMS, Citrix, Sabre,

Exceptional problem solving, effective communication and customer service skills

Solid experience in all phases of managed care, commercial health insurance, Medicare Part B, Medicare Part C, Medicare Part D insurance, and Prescription Benefit Management

Proficient use of MS Office products Word, Excel, and Power Point

Superior leadership direction and guidance for a team to be awarded Supervisor of the Quarter for two consecutive quarters.

Education

Collin County Community College, Frisco TX

San Bernardino Valley College, Colton CA

Riverside Community College, Riverside CA

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