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Customer Service Representative

Beeville, TX
January 30, 2024

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Domonique Middleton

**** ******** ***** ********, ** 78102


Customer Service Representative with 5+ years of experience using excellent communication skills, strong de-escalation experience, and ability to learn and retain knowledge quickly to assist customers in resolving questions and issues. Varied experience in both food service, healthcare, and corrections has equipped me with the ability to use a wide variety of skills to get the job done.


SEPTEMBER 9, 2021 – FEBRUARY 2, 2024

Customer Service Representative Tier 4/Sagility Healthcare WFH

Answered large number of incoming calls for both Humana Medicare members and providers.

Reviewed benefits and located providers for members

Reviewed claims and compared to benefits to ensure all claims are being paid correctly

Use CRM to locate members accounts and accurately document all calls

Submitted appeals for prior authorizations received by both members and providers. Gave status and gave next steps when needed.

Completed provider credentialing by using primary source verification, such as SAMS, DEA, CAQH

Reached out to providers and members when more information was needed to resolve issue.

Used training and database researched to educate members on their benefits and Healthcare plans.

Assist members with billing related concerns.

APRIL 2016– AUGUST 2020

Correctional Officer IV/Texas Department of Criminal Justice, Beeville, TX

Maintained custody and control of offenders

De-escalated conflicts between offenders, offenders and staff, and staff

Addressed inquiry from staff, offenders, offender’s family, and general public

Prepared and maintains logs, reports, and records

Kept track and issued all keys and equipment

Worked within tight policies and procedures to maintain a controlled and safe environment.


Customer Service Representative/McDonald’s, Beeville, TX

Trained new employees

Greeted customers and provided excellent service

Inventoried stock

Recorded orders

Completed cash and card payments when necessary.


Type 60WPM

Proficient with Microsoft applications such as PowerPoint, Word, and Excel

Team player

Excellent time management skills

Conflict Management

Fast learner and ability to adapt and retain knowledge

research skills

Multiline phone proficiency

Suicide prevention training.


MAY 2017

Associates of Science/Coastal Bend College, Beeville, TX

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