Customer Service Representative
Resume:
Janet Powell
***** *********** **, *** ****
Houston, TX 77077
**********@***.***
Experience
**/**/**** – 03/26/2024
Remote Customer Service Rep: Cigna Evernorth – Sup Kinia Mullin
Patient Care Advocate II /Medicare Part D
Answer incoming customer calls regarding the status of their prescriptions. Perform drug covered. Explain to member how their plan works.
10/16/2018 – 05/31/2020
Customer Service Representative – Help Desk- Aerotek – Supervisor Breana Sanchez
Answers incoming customer calls regarding not being able to access the website, product problems, service questions and general client concerns. Responsible for maintaining a high level of professionalism with clients and working establish a positive rapport with every caller. Update customer information in the customer service database during and after each call. Work with the management team to stay update on product knowledge and be informed of any changes in company policies. Perform related duties.
11/10/2017 – 09/21/2018
Customer Care Advocates – Medicare Advantage Part C Program – Convey Health Solutions
Received inbound calls from Medicare Beneficiaries enrolled into Part D Drug Plan (PDP) or a Medicare Advantage Part C Program (MAPD). Assist beneficiaries with updating account information, providing plan information resolving issues with utilization of the plan, and taking orders or reorders for products sponsored by the plan (s), e.g. OTC. Perform related duties.
07/17/2017 – 09/21/2017
Phase 1 Gap Claim Processor – Phase 1 Processor – Global Response
Analyze and process the insurance claim, checking documents for validity. Review all documents to ensure that all questions have been answered, compiling data on gap claim policies change, modifying policy records to conform to insured party specifications, compiling data on lapsed insurance policies to determine automatic reinstatement accord to company regulations. Performed related duties.
11/012010 – 03/14/2017
Medical Biller – Medical Biller Processor – Amsurg
Review and process claims for 11 multi-specialty facilities. Process claims for Private, Medicare and Medicaid and Commercials and Workers Compensation. Prepare and submit clean claims to payers either electronically or paper claims. Perform related duties.
08/23/2006 – 09/10/2014
Order Entry – Order Entry Representative – QVC
Received inbound calls from customer who wish to purchase items presented on the QVC platform. Identified, respond and resolved customer concerns using all available resources in order to retain or recover profitable customer relationships with QVC. Performed related duties.
Education
Broward College, Coconut Creek, FL
* Associate of Science
* Major Health Information Management
* Minor Applies Science Technology for Medical Coder\Biller
Skills
Professional Coding 2015 at IRSC
ICD-10CM and HCPCS Coding Systems
Medical Records, Medicare and Medicaid, Workers Compensation and Commercial insurance billing guidelines
Learn how to comply with National Fraud and Abuse Initiatives in coding and reimbursement for coding disciplines
Past experience in Hospital, Ambulatory, Financial systems
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