Customer Service Specialist
Resume:
Erika Marable
Cape Girardeau, MO *****
**********@*****.***
My goal is to become an employee of a cutting-edge company where I can utilize my service orientation acumen to contribute to the long term goals of the company. I am a highly driven and self-motivated employee, and proficient in problem resolution.
Authorized to work in the US for any employer
Work Experience
Customer Service Specialist
Provider Plus-Cape Girardeau, MO
February 2023 to Present
• Develop and maintain working knowledge of current products and services offered by the company
• Answer all calls and emails in a timely manner, in adherence to their goals
• Facilitate resolution on customer complaints and problem solving
• Process orders, and follow up with customers when necessary
• Complete insurance verification to determine patient eligibility, coverage, co-insurance and deductibles.
• Obtain pre-authorization if required by insurance carrier and process physician orders to insurance carrier for approval and authorization when needed. Client Benefit Manager / Commercial Account Manager Express Scripts-St. Louis, MO
July 2014 to March 2020
• Responsible for overall satisfaction and retention of assigned book of business.
• Manages day to day client relationships through comprehensive knowledge of client's benefit its plan and Express Scripts product offerings.
• Responsible for timely and accurate management and execution of all client benefit it requests, including benefits changes, product upsells, new groups, terminations and escalated issues.
• Accountable for new group and specific product implementations; including establishing and leading internal meetings to ensure collaboration and attention to detail throughout the process in order to meet expected timelines and quality standards.
• Lead client CDH meetings to review ESI's operational performance against client's expectations and need
Personal Injury Adjuster
Fireman's Fund Insurance-St. Louis, MO
October 2006 to July 2014
* Manage a high volume workload with a client portfolio averages 50-75 clients; caseload of 150-350 claims
* Responsible for clear and concise documentation of relevant information
* Analyze portfolio and responsible for settling liens and arbitration
* Responsible for conducting investigations and creating detailed action plans
* Held several Property & Casualty Licenses in multiple states Customer Relations Specialist
United Health Group-St. Louis, MO
January 2004 to December 2006
* Handled customer inquiries, complaints, billing questions for members' health claim issues
* Built rapport with members, listened carefully and managed conversational flow
* Resolved an average of 500 inquiries per week and met performance benchmark consistently
* Earned 100% marks in areas such as, communication skills, listening skills, problem resolution and soft skills
* Handled emotional customers with delicacy, listening empathetically while maintaining company policy Customer Service Agent
GMAC Insurance-St. Louis, MO
April 2002 to September 2004
* Provided professional insurance counsel to GMAC insured's regarding their policy needs
* Managed the resolution process for policy holders
* Enforced company guidelines and exercised full underwriting authority
* Manage upset customers, conflicts, and challenging situations
* Worked in a team, but in a self-directed environment Education
Associates Degree in Office Technolgy/Applied Science Northwestern Business College - Chicago, IL
May 1993 to May 1995
Skills
• Benefits Administration
• Workers' Compensation
• PeopleSoft
• Microsoft Excel
• ICD coding
• Microsoft Word
• Microsoft Office
• Insurance verification
• Business requirements
• ICD-10
• Medical Billing
• Medical coding
• Medical office experience
• CPT coding
• Medical billing
• Medical Scheduling
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