Customer Service Representative
Resume:
● Keesha Lewis
***********@*******.***
Career Overview
Highly enthusiastic customer service professional with 20 years client interface experience. Dedicated Customer Service Representative motivated to maintain customer satisfaction and contribute to company success .Customer-focused Representative with a proven capacity to troubleshoot issues to ensure customer satisfaction. Worked directly with clients to resolve issues.
Core Strengths
•High customer service standards Service solutions expert
Multi-channel contact center software Telecommunications knowledge
Customer Relationship Management software Strong organizational skills
Work Experience
Referral Specialist
March 2017-present
Nebraska Total Care
•Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations.
•Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list. Route to appropriate staff when needed.
•Verify eligibility and benefits
•Answer phone queues and process faxes within established standard
•Data enters authorizations into the system.
Member Service
September 2016 to March 2017
Nebraska Total Care
•Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner.
•Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
•Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment
Assisting providers and members with Medicaid insurance claims
Medicare Member Research Specialist
May 2010 to February 2016
Prime Therapeutics Omaha, NE
•Worked directly with Medicare member’s prescription insurance.
•Created new processes and systems for increasing customer service satisfaction.
•Worked Medicare Grievances and Inquires to resolve members issues.
•Provided accurate and appropriate information in response to customer inquiries. Worked with upper management to ensure appropriate changes were made to improve customer satisfaction.
•Assisted with the development of the call center's operations, quality assurance and training processes
•Exceeded corporate target for customer satisfaction four consecutive months in a row. Promoted twice in 5 years.
•Completed all assigned tasks, working overtime as needed. Managed call flow with up to numerous calls in queue per minute.
Member Rewards Customer Service
May 2008 to April 2010
First Data Omaha, NE
•Assisted member with redeeming the membership rewards points earned while using their credit cards.
• Answering questions about customers membership rewards and entering orders into system for processing
•Learned new membership rewards products.
•Researched, calmed and rapidly resolved client conflicts to prevent loss of key accounts.
August 2006 to May 2008
•Actively looking for full time work while working part time jobs.
Educational Background
Associates degree: Business Management, 2006 2.7 GPA
Metropolitan Community College, Omaha,Ne USA
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