Maurice Wallace

Milwaukee, WI

Summary:

●Ideal candidate for an innovative and progressive company seeking a talented and professional customer service leader to join their growing team.

●Ability to utilize diplomacy, tact and problem solving to effectively service internal and external customers.

●Self-starter, hardworking and detail orientated.

●Energetic, positive demeanor, with a verifiable record of motivating self and others to meet objectives.

●Strong organizational skills; demonstrated talent for managing a constructive/diverse schedule

●Perform effectively both as an independent, self-motivated individual and as an active contributing team member

Education:

ITT Technical Institute - Greenfield, WI

Associates of Science – Aug 1998

Skills:

●Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook)

●Customer Service

●Clint Retention

●HIPAA

●Knowledge of Medicare, Medicaid and Healthcare Marketplace insurance

●Knowledge of Banking Products and Services

●Case Management

●CRM

●Escrow Account Maintenance

●Claims Processing

●Over 10 years in high volume inbound call centers

Professional Experience:

Iconma (Briggs And Stratton) May 2023 – Sep 2023

Marketing Associate Specialist

●Monitors and reviews cooperative advertising claims submitted by dealer/installers and other customers

●Collaborates with sales and marketing management to define cooperative advertising program rules and guidelines.

●Submit approved claims to the finance and accounting team for check processing and distribution of rebate payments.

●Assist in drafting, editing and proofing copy for marketing communications such as email announcements, newsletters, printed collateral and digital content.

●Monitors advertising budgets and uses spreadsheets to track and report on expenses.

●Distributes prepared marketing materials to internal and external stakeholders.

●Maintains client loyalty by serving customers above and beyond their expectations.

●Performs other duties as assigned

●Answered the billing and medical questions of 1K patients weekly by adhering to confidentiality agreement, HIPAA and company policies.

AbbVie Nov 2022 – Feb 2023

Client Specialist II

●Verify to make sure clients are eligible for specialist medication.

●Receives inbound client requests that derive from tickets.

●Engages clients to resolve questions and requests.

●Analyzes semi-complex problems, identifies solutions and executes to solve them with leadership supervision.

●Provide accurate, friendly and responsive service to customers.

●Maintains client loyalty by serving customers above and beyond their expectations.

●Answered the billing and medical questions of 1K patients weekly by adhering to confidentiality agreement, HIPAA and company policies.

●Resolved complaints of 2K customers, logged billing discrepancies and ensured claims were processed and paid within 48 hours using EPIC computer system.

Wisconsin Healthcare Jan 2022 – Sep 2022

Customer Care Coordinator

●Assisted customers with Medicare, Medicaid and Healthcare Marketplace insurance issues.

●Took inbound calls either from patients or providers regarding various insurance enquiries, questions about claims.

●Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.

●Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.

●Supports payer research, health care policy library, and state management.

●Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

●Typically receives little instruction on day-to-day work, general instructions on new assignments.

●Performs related duties as assigned.

Skygen Oct 2017 – Feb 2021

Customer Service Representative

●Assisted with Medicare and Medicaid claims and remittances.

●Took inbound calls either from patients or providers regarding various insurance enquiries, questions about claims.

●Responsible for all areas of customer service as it pertains to research and resolution of telephone inquiries related to Plan prescription benefits, eligibility or claim payment issues.

●Provide quality service and customer satisfaction through effective communication and education.

●Update claim information based on research and communication from member or provider.

●Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)

●Also made outbound calls

●Learn and leverage new systems and training resources to help apply claims processes/procedures.

●Assisted dental and medical providers with online portal issues.

Wells Fargo Home Mortgage Sep 2012 – Oct 2017

Customer Service Representative II

●Assisted customer with general home mortgage inquiries.

●Handling difficult Escrow account issues.

●Assisted customers insuring they had the products and services that best fit their banking needs.

●Took a high number of incoming calls while meeting sales and retention goals.

●Insured all needs were met to insure one call resolution.

●Assisted customers with complex monthly statement inquiries.

●Assisted customers with all billing issues.

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