Customer Service Associate

Deborah Ann Willis

Plano, TX 267-***-****

************@*****.***

Experienced Customer Service Associate

Adaptability Leadership Change Management Problem Solving

Results-driven Customer Service Associate with 43 years of experience in the healthcare industry, excelling in high-volume call center environments. Adept at resolving complex customer inquiries, fostering patient satisfaction, and maintaining HIPAA compliance. Seeking to leverage expertise in problem-solving, patient communication, and service optimization to contribute to a dynamic healthcare team focused on delivering exceptional care.

Core Competencies

Customer Relationship Management (CRM)

HIPAA Compliance

Patient Inquiry Resolution

Effective Communication

Call Center Operations

Data Entry & Documentation

Service Quality Assurance

Team Collaboration & Support

Regulatory Compliance and Governance

Customer Focus

Data-Driven Decision Making

Professional Experience

Ada Louise Inc. – Remote, Dallas, TX 11/2022 – Present

Senior Customer Service Associate

Provides our customers with world-class customer service.

Strategically partners with volunteers to improve the customer experience.

Help resolve any questions or concerns our existing customers may have.

Assist our homeless customers with securing safe housing quarters.

Manages various fundraising projects.

Solicits donations.

Secures various products, perishables, clothing items, etc. for our distribution center.

Self Employed – Philadelphia, PA 12/2016 – 11/2022

Live-In Nanny

Created and implemented engaging age-appropriate activities to support children's development.

Managed daily tasks including meal preparation, feeding, dressing, and bathing.

Assisted with homework, school projects, and extracurricular activities.

Ensured the well-being and safety of children through constant supervision and a nurturing approach.

Coordinated with parents to align on family schedules and routines.

Maintained an organized living space and ensured cleanliness in children's areas.

Provided emotional support and conflict resolution to help children manage behavioral challenges.

Adapted to changing needs of the household, offering flexibility and reliability.

Blue Cross Blue Shield – Philadelphia, PA 2007 – 12/2016

Customer Account Contact Specialist

Managed high-volume inbound and outbound calls to address customer inquiries, billing questions, and account issues for Amerihealth, Keystone, IBC, Personal Choice, CMM, Medicare Supplemental and Traditional lines of Business.

Provided accurate and timely information regarding products, services, and account updates to clients.

Resolved complex customer concerns with a focus on first-call resolution and customer retention.

Processed account adjustments, billing corrections, and payment arrangements to ensure account accuracy and customer satisfaction.

Documented all customer interactions and updates within CRM systems for accuracy and compliance.

Collaborated with internal departments to ensure seamless customer service and account management.

Functioned as the liaison between Brokers, Group Leaders, and Marketing Leadership in regard to enrolment, billing, and medical claims issues.

Delivered exceptional service by maintaining a professional and empathetic approach in every interaction.

Assisted in onboarding new customers and provided guidance on account setup and features.

Analyzed account data to identify opportunities for upselling or cross-selling additional products and services.

Client Broker Services Representative for Amerihealth Client 2004 – 2007

Acted as a liaison between brokers, clients, and internal teams to ensure smooth processing of transactions and account updates.

Supported brokers by providing detailed account information, trade confirmations, and assistance with account changes.

Handled inquiries related to account management, investment products, and service requests in a timely and professional manner.

Ensured compliance with regulatory requirements and internal policies during account setup, transfers, and transactions.

Processed documentation for new accounts, ensuring accuracy and timely completion of client onboarding.

Maintained accurate and up-to-date records of client interactions and account activities in CRM systems.

Assisted clients with troubleshooting issues related to account access, statements, and trade execution.

Collaborated with internal teams to address escalated issues and deliver resolutions to brokers and clients promptly.

Delivered exceptional service by maintaining a thorough understanding of financial products and services, providing expert guidance to clients.

Team Services Representative/Claims Adjuster 2000 – 2004

Investigated and assessed claims, gathering relevant information and documentation from policyholders, witnesses, and third parties.

Analyzed policy coverage and applied regulations to determine claim validity and settlement amounts.

Collaborated with internal teams and external partners, including medical professionals and repair shops, to ensure accurate claim processing.

Communicated claim status and decisions to policyholders, offering explanations and guidance to ensure transparency and customer satisfaction.

Negotiated settlements with claimants, attorneys, and third-party representatives to resolve disputes and achieve fair outcomes.

Maintained up-to-date case files and detailed records in claims management systems, ensuring compliance with company policies and industry regulations.

Handled a high volume of claims, managing multiple cases simultaneously while meeting deadlines and service level agreements.

Provided support and guidance to team members, contributing to a collaborative and productive work environment.

Delivered empathetic, customer-focused service, helping clients navigate stressful situations with professionalism and care.

Senior Claims Representative 1997 – 2000

Managed a portfolio of high-value, complex claims, including liability, property, and casualty cases, from initial investigation through to settlement.

Conducted thorough investigations, gathering evidence from policyholders, witnesses, and external experts to evaluate the legitimacy and extent of claims.

Interpreted and applied policy terms and legal guidelines to determine claim coverage, liability, and settlement values.

Negotiated settlements with claimants, legal representatives, and third-party vendors to ensure fair and timely resolutions.

Provided expert guidance to junior claims representatives, offering mentorship and assistance with complex cases.

Communicated regularly with policyholders, providing clear updates on claim status, next steps, and potential outcomes.

Collaborated with legal teams, medical professionals, and external vendors to ensure accurate and fair claim resolutions.

Maintained detailed and accurate claim documentation in compliance with company policies and industry regulations.

Identified potential fraud and escalated cases for further investigation when necessary.

Delivered superior customer service, ensuring a positive claims experience by handling all interactions with professionalism and empathy.

North Philadelphia Health Systems – Philadelphia, PA 1981 - 1997

Lab Assistant and Phlebotomist

Performed venipuncture and capillary draws on patients of all ages, ensuring a comfortable and efficient blood collection process.

Collected and labeled blood, urine, and other specimens following proper identification protocols to maintain sample integrity.

Prepared specimens for laboratory analysis by processing and centrifuging samples according to established guidelines.

Assisted laboratory staff in conducting routine tests and maintaining a clean, organized workspace.

Maintained accurate patient records and ensured timely and efficient data entry into lab information systems.

Followed strict safety, sanitation, and infection control protocols to protect patients and staff in a clinical setting.

Provided clear instructions to patients for at-home sample collection and answered any questions regarding the process.

Assisted physicians and nurses by delivering lab results promptly and communicating urgent findings.

Managed inventory and ensured laboratory supplies were adequately stocked to avoid disruptions in daily operations.

Demonstrated empathy and professionalism when working with patients, particularly those with anxiety about needles or medical procedures.

Strawbridge and Clothier – Philadelphia, PA 1980 - 1985

Assistant Department Supervisor

Assisted the department supervisor in overseeing day-to-day operations, ensuring all tasks were completed accurately and on time.

Managed a team of employees by providing training, guidance, and support to ensure optimal performance and adherence to company policies.

Monitored team productivity, identified areas for improvement, and implemented strategies to enhance efficiency and service delivery.

Delegated tasks and responsibilities to team members, ensuring balanced workloads and clear communication of priorities.

Acted as the primary point of contact in the supervisor’s absence, resolving issues, handling escalations, and making decisions to maintain workflow.

Conducted quality control checks to ensure department output met established standards and client expectations.

Assisted in the development and implementation of department goals and performance metrics to drive continuous improvement.

Collaborated with other departments to coordinate projects, streamline processes, and enhance overall organizational efficiency.

Provided regular feedback and performance evaluations for team members, supporting professional growth and development.

Ensured a safe, organized, and productive work environment by promoting adherence to safety regulations and company policies.

Education

Business Administration 2013

Pierce College

Healthcare Business 1997

Health & Technology of Philadelphia

Contact this candidate