Customer Service Call Center
Resume:
Pangnra S. Moua
Merced, CA *****
Mobile: 209-***-****
Email:***********@*****.***
Summary
Deliver and communicate effective expert assistance with a positive persona by putting our communities and members at the center of business decisions. Result driven Medical Professional with 10 years of Customer service experience looking to obtain a medical profession that utilizes my skills and training to the best of my abilities. Passionate individual that wants to improve the health of the community we serve.
EXPERIENCE
Telecom, Inc., July 2024- Present
Customer Service/Call Center Representative- Medical Claims
Receive incoming calls from providers to resolve claims; utilize judgment and problem-problem solving skills to deliver accurate information in a timely manner
Maintain telephone etiquette with patients, third parties, and public which reflect an image of dependability, competence, firmness and politeness.
Follow department and Company Policies
Demonstrate knowledge of Insurance Payer types
Demonstrate knowledge of proper coding and processing of in-coming Explanation of Benefits and Remittance Advice
Review and resolve all correspondence
Review Aging Report each month for all designated accounts
Responsible to respond to provider inquiries on authorizations, claim status, benefit designs, and claim payments
Respond to e-mails in a timely manner
Review vouchers/explanation of payments to identify and resolve claims related issues
Continually meet department performance measures as it relates to production, accuracy, knowledge of policy and procedure and timeliness of claims adjudication
Analyze, identify and research, as needed, edits which demonstrate inconsistency regarding policy, payment issues and coding issues
Efficiently navigate through systems and applications to locate information specific to claim scenarios
Accurately locate resources and read, interpret, and apply appropriate information to various claim scenarios
Identify and communicate process opportunities or improvements
Note accounts in detail of all actions taken
Wells Fargo Bank, Dec 2013 – June 2023 Merced, CA
Personal Banker:
Schedule appointments and verify customer information.
Answered customer telephone calls in a professional manner to provide customer inquiries and follow up on inquiries
Handle or refer member inquiries as appropriate
Documented phone calls and referrals.
Update member information in company system
Organized and secure customer confidentiality, and marketing services.
Supported customers by coordinating special actions like ordering new bank cards and personal checks.
Prepare and process deposits, and payments to the appropriate account
Increased product appeal and customer experience by interacting with customers.
Analyze accounts receivable and payable, internal and external reports, and levy documents.
Analyze money orders and cashier checks report for inquiries, and research.
Assist management with preparation of training, projects and audits as needed
Researched, troubleshot, and resolved customer and internal inquiries regarding policies, practices, and products.
Verified the integrity of deposit checks and money orders to protect customers and the bank from fraud.
Demonstrate leadership skills that enable the processing of high work volumes.
Ensure on-the-job injuries are properly reported and documented
Process order inventory quarterly, labeling items and arranging according to immediate need.
Customer Service Sales Representative:
Schedule appointments and verify customer information.
Manage incoming calls and resolve customer inquiries.
Generate sales leads that develop into new customers.
Identify and assess customer needs to increase product appeal.
Analyze account activities and research customer inquiries
Build customer relationships and trust with customers’ accounts through interactive communication.
Opened, maintained, and closed customer’s accounts upon request and secure customer interaction documents.
Coordinate customer outreach, and appointments.
Follow communication procedures, guidelines, and polices.
Bank Teller:
Provide customer service with warm greetings and process transactions upon request.
Process deposits, check cashing, payments, money orders and cashier checks.
Uphold consumer privacy, bank policies and procedures.
Counting and packaging currency following dual control procedures.
Exchange foreign currency.
Promote bank products and services such as checking and savings accounts, loans, credit cards and certificates of deposits.
Maintained accurate and balanced cash drawers by carefully counting funds and quickly investigating any discrepancy.
Waitress, Denny's Restaurant, Jun 2010 - Jun 2013, MERCED, CA
Engaged customers in friendly conversation to build connections and increase satisfaction.
Checked with customers to ensure satisfaction and correct any issues.
Explained daily menu offerings, drink specials, and seasonal items and recommended options based on customer preferences.
Supported hostesses and bussers with seating and table-clearing throughout high-volume shifts.
Delivered personable and attentive service to all patrons, including seating assistance, order management, and special requests.
Prepared itemized checks, including total meal costs and sales taxes.
Quickly addressed and resolved customer concerns, working with management to fix advanced issues.
Wrote patrons' food orders on order slips, memorized orders, and entered orders into computers for transmission to kitchen staff.
Used slow periods to stay on top of side work such as restocking serving stations and wrapping silverware.
Volunteer:
CGI Safe House, Jun 2010 - Sep 2011, Merced, CA
Provide a safe and secure environment for children’s safety.
Review court order documents for supervised visits.
Ensure the safety of the room measures are maintained for child safety.
Observer, document, and report child abuse to authorities.
Ensure child and clients safety of confidentiality.
Maintain compliance with state and regulations and court orders.
Prevent uncomfortable interruptions or ending visit if necessary.
SKILLS
Customer Service / Appointment Scheduling
EHR / Microsoft Office Suite / Google Docs
ICD-10 CM / CPT / EM / Modifiers / HCPCS II Coding
HIPAA / Medical Terminology / Anatomy & Physiology
Accounts Receivable / Payable / Aging Reports
Internal & External Medical Audits / Compliance Plans
Government Insurance / Tricare / Medicare / Medicaid
Managed Care / PPO / HMO
Collection Strategies / Revenue Cycle
Bilingual: Hmong- Read/Speak- Fluent
47 WPM, 14,100 KSPH
Salesforce, Meditrac, Zyter/Truecare, PowerBI, HealthEdge, Ring Central, Remote VDI, Citrix
EDUCATION
Career Accelerated Learning Regional- June 2024-Aug. 2024
Billing and Coding Specialist
High School Diploma Merced High School: 2003-2007
Merced Junior College- Associate in arts degree Aug. 2022- May 2024:
Administration Medical Office Professional
Administrative Office Professional
Certificate
BLS Certification, Aug. 2024- Aug. 2026
National Healthcareer Associate Certification, June 2024- Aug. 2024
Certificate of Completion in Health Insurance, CPT Coding and ICD10 Coding, Aug. 2023-Dec. 2023
Certificate of Completion in Administrative Office, Aug. 2022- May 2024.
Notary Public Certified, April 2022- July 2026
References
Shawna Ochoa
Social Services Program Coordinator
Meuy Saelee
Project Manager
Donna Yufanyi
Telecommunications Supervisor
Mercy Hospital
Sarah Moua
Executive Assistant
Loretta’s Little Miracles
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