Customer Service Call Center
Resume:
Diane Browning
Arlington, Texas 76006
ad5sjk@r.postjobfree.com
Summary of Qualifications
Successful in overall operations in a fast-paced Call Center for over 10 years, with an in-depth knowledge of Customer Service, Collections, and Medical Billing
Exemplary track record of establishing and maintaining productive work environments and relationships
Proven aptitude to analyze and translate complex customer requirements, business problems, and process improvement
Quality-focused Professional with strong analytical, organizational, and problem-solving skills, committed to the highest levels of ethical, professional, and personal excellence
Works effectively with cross-functional teams to ensure Operational and Service Excellence
Excellent strategic planning skills, record accuracy and strong dedication to the implementation of processes and controls to enhance business profitability Professional Achievements
9/2020 – 10/2022 Patient Service Coordinator, Healthcare Associates of Texas, Bedford, TX
Account reconciliation and implementation of collections efforts and/or settlements from customers and insurance companies
Adhered to HIPAA privacy laws and maintained high Quality Assurance standards
Supervised and evaluated associate’s performance and provided the necessary feedback for performance enhancement
Performed employee evaluations and conducted calibration sessions on recorded customer interactions for Quality Assurance, Compliance and Service Excellence 6/2017– 7/2019 Mail Order Pharmacy Representative, Humana Mail Order Pharmacy, Irving, TX
Managed inbound calls for Humana Mail Order Pharmacy Customers and assisted with ordering medications
Assist customers with accessing their online pharmacy account and educating members on their prescription plans
Collected patient demographics, medication names, strengths, quantities, etc.
Provided information as requested or needed, to clinical pharmacists and other staff, to assist in the accurate and timely completion of reports and medical reviews for various clients
Processed payments and set up delivery of prescription medications
Provided oversight on all critical interdepartmental escalations to ensure customer retention
Served as the first point of contact for all customers and provided World-Class Client Service 8/2012 – 5/2017 Credit Specialist, Relleyvent Solutions, Addison, TX
Provided client consultation for credit analysis and served as liaison between client and creditors for debt resolution
Maintained timely and accurate preparation of dispute letters and submitted letters to creditors
Negotiated settlements with creditors on behalf of client
Maintained quality service through customer relations
Referred customer to mortgage lender to pre-qualify for home loan 1/2004 – 1/2012 Account Specialist/Mentor National Patient Account Services, Bedford, TX
Followed delinquent accounts and implemented appropriate steps for collection or settlement from customer and insurance companies for all HCA hospitals
Administrative support for 15 call center agents, initiated coaching and feedback sessions, with a focus on Quality Assurance, soft skills, and process improvement
Consistent delivery of Best-in-Class Customer Service, and provided oversight to the success of departmental objectives, policies, and procedures.
Trained and monitored staff performance to deliver on KPI/Metric targets and developed new initiatives to enhance existing policies and procedures
Answered inbound and made outbound calls on a predictive dialer system in support of customer needs
Reviewed accounts for discrepancies and made requests for hospitals to audit account information and processes to identify whether investigation for Coordination of Benefits, or other Third-Party Liability was necessary
Billed insurance in a timely manner and corrected and re-billed claims based on payer responses
Received ongoing recognition for Excellent Customer Service (Kudos), Perfect Attendance Award, Highest Credit Card and Check By Phone Award Recipient, 7 Year Recipient of Millionaire’s Club Award
Education & Certifications
General Studies Seattle Central College, Seattle, Washington National Patient Account Services Certified Trainer Skills
NextGen, CRM, Vista, CRM, AS400, Intelec, Genysys, Zendesk, Account Reconciliation, Explanation of Benefits, UNET, Billing, Medicare Prescription Drug Plans, Medicare Supplements, Medicare/Medicaid Reimbursement, Medicare Part D, Dispute Resolution, Collections, Employee Mentorship, Copiers, Data Entry, Debtmaster, NICE, Filing, Skip Tracing, Windows, Microsoft Office, Excel (V-Lookups and Pivot Tables), Salesforce, ADP, Billing, Quality Assurance, UltiPro, Microsoft 365, Avaya
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