Customer Service Call Center

Brandi Tellgren

325-***-**** ******.*********@*****.*** Abilene, TX 79603

SUMMARY

I am committed and offer over 9 years of solid skills in customer relations and resilience to handle challenges of fast-paced environment. Brining detail oriented and decisive nature with sound judgment, goo multitasking abilities and a self-motivated personality. I am comfortable working alone or with a team to accomplish on-time and accurate tasks.

SKILLS

Call center experience

Health products knowledge

Detailing plans

Customer service

Claims

Presentations and Flow charts

Sales expertise

Organized and detail oriented.

HIPAA guidelines

Computer skills

Excel sheets and Microsoft

adaptability

EXPERIENCE

BlueCross and BlueShield, February 2020-Current

Abilene, TX -$23.74 Hourly

Worked ERS as a Personal Health Assistant (PHA) from February 2020- February 2023

Assisted with TRS for 3-4 months. In my first year of working at Blue cross and Blue Shield

Answered questions on diverse topics, including authorization procedures, referrals, and benefits.

Answered calls and interacted with community members to provide information on advocacy services.

Assist participants on their plan and go over their benefits and what is required for their plan.

Direct calls to the correct department when questions do not pertain to medical.

Process Claims

Followed established guidelines and procedures.

Participated in Seminars and additional training to expand knowledge and skills.

Utilized downtime to perform routine tasks, preventing service delays.

Provider written “reviewed provider requests and sent determination letters after review”

Maintained inventory.

Became learning coach for new hires,

Provided feedback as a learning coach.

Clinical appeals

Followed procedure flow to assure the EAA was filled out correctly and address were correct for any providers and participant prior to sending acknowledgment letters and routing to medical directors for review due to HIPAA

Worked back-end process of appeals to ensure that all information was filled out correctly per the flow prior to sending determination letters.

Worked assigned cases and projects.

ERS Appeals

Make contact to members and providers to verify information and any additional information pertaining to an appeal.

Do extensive research on claims to determine if the services can be allowed due to any exception or if it was a provider or insurance error.

Get referrals for the member if they have future appointments scheduled with a specialist.

Send emails to provider network to verify provider status.

Create letters for appeals such as acknowledgment and custom determination letters.

Follow HIPAA compliances.

Started Level 2 appeals 7 months into being an ERS appeals specialist II.

Work ERS appeals along with assisting with Triage RCIPs and routes.

Provide Feedback to PHAs

Assist in Host backend inquiries.

Motorclothes Associate, Kent's Harley Davidson Honda & Suzuki, September 2016-June 2020

Abilene, TX -$11.00 hourly

Answer phones and provided information to callers, take messages, or transfer calls to appropriate department.

Greet visitors or callers and handle their inquiries and direct them to the appropriate departments according to their needs.

Order and dispense supplies.

Maintain cash drawer.

Maintain the stores appearance.

Receive new inventory and input into the system.

Order Merchandise

Special Orders

Sales Associate, Beall’s, February 2014-October 2016 - $7.50 Hourly

Abilene, TX

Greet customers and ascertain what each customer wants and needs.

Describe merchandise and explain use, operation, and care of merchandise to customers.

Recommend, select, and help locate or obtain merchandise based on customer needs and desires.

Answer questions regarding the store and its merchandise.

Compute sales prices, total purchases and receive and process cash and credit payment.

Help customers try on or fit merchandise.

Place specials orders or call other stores to find desired items.

Open and close cash registers, performing tasks such as counting money, separating charge slips, coupons and vouchers, balancing cash drawers and making deposits.

Watch for and recognize security risks and thefts and know how to prevent or handle these situations.

Inventory stock and requisition new stock.

Exchange merchandise for customers and accept returns.

Bad or package purchases and wrap gifts.

Clean shelves, counters, and tables

Internet Help Desk, Teleperformance, June 2016-September 2016

Abilene, TX - $10 Hourly

Answer phones and give information to callers, take messages, or transfer calls to appropriate department.

Trouble shooting customers internet, landlines and Wi-Fi.

Make appointment for technicians to go to customer’s house.

Verify outages.

Virtually get into customers computers with their permission to help them with any Wi-Fi issues.

EDUCATION AND TRAINING

High School Diploma

Hawley High School, Hawley TX May 2016

Southern New Hampshire University, Manchester, NH

Certification in National Society in Leadership and Success

Associate in business administration 2022- 2024

Bachelor’s in business administration with a concentration in accounting January 2024-Present

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