Customer Service Representative
Resume:
TH
TAYLOR HILL
Professional Summary
Committed to ensuring customer satisfaction by providing exceptional service and unmatched support. Proficient in utilizing customer service best practices and adept at exploring different solutions to address customer needs effectively. Work History
Elevance Health - Healthcare Customer Service Representative/Claims Representative
Remote
01/2021 - Current
Revolution Financial Management - Customer Service Representative/Data Entry Clerk
Remote
04/2018 - 01/2021
Supreme Team Medical Group Inc - Healthcare Customer Service Representative/Chat Support Representative
Remote
02/2015 - 04/2018
Answering inbound calls, emails, and chats from customers regarding their healthcare claims. Providing clear and accurate information about claims status, benefits, and coverage.
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Assisting customers with understanding their Explanation of Benefits (EOB) statements
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Verifying claims information and ensuring completeness and accuracy. Coordinating with healthcare providers and insurance companies to resolve claims issue
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Investigating and resolving claims discrepancies and issues. Researching denied or rejected claims to determine the reason and provide solutions..
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Handle a high volume of inbound and outbound calls to assist clients with financial service inquiries, ensuring professionalism and timely resolutions.
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Respond to customer questions about services, account statuses, and payment inquiries.
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Provide guidance and troubleshooting for any issues clients experience with financial accounts or transactions. Accurately input customer and financial data into the company's CRM systems (Customer Relationship Management software).
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Ensure all customer details are correctly documented, including financial reports, transaction records, and service logs.
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Respond to a high volume of inbound chat inquiries from patients and healthcare providers regarding medical services, billing, insurance, appointments, and general healthcare information.
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Provide accurate and clear answers to patient questions related to healthcare services, medical procedures, and insurance coverage.
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Assist patients with locating healthcare providers, understanding service options, and scheduling or rescheduling appointments.
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Maintain and update patient records with new information such as appointments, contact details, or updates to health insurance coverage.
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***********@***.***
Houston TX
Skills
Claim Appeals Handling
● Insurance Verification
● Call center experience
● Appointment Scheduling
● Medical terminology knowledge
● Email Support
● Remote Operations
● Call Center Operations
● HIPAA Compliance
● Customer Service
● EMR
● Insurance Billing
● Problem-Solving
● Payment Processing
● Financial Procedures Adherence
● Eligibility Determination
● Attention to Detail
● Time Management
● Data Analysis
● ICD-10 Proficiency
● Medicare Expertise
● HIPAA knowledge
● EOB Analysis
● Claim Denials Management
Education
California State University-Northridge
Northridge, Houston
Bachelor of Science
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