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Customer Service Representative

Phoenix, AZ
January 10, 2020

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Tonya Hardy-Jones

*** * **** ** *** **** Phoenix, AZ 85022

Cell: 480-***-****

Skills, Knowledge, and Abilities

Mature, polished, and focused

Answer high volume of calls

Appointment scheduling

Ability to learn new task quickly and efficiently

Cheerful outlook with a positive attitude

Typing 40 WPM

Billing and collection

Knowledge of PPO/HMO and AHCCCS and Medicare Insurances

Office Management

Cerner,MS4, McKesson, Epic, NexGen

Knowledge on obtaining authorizations

Workforce manager, CEM, Daily Productions log, and Verint Impact, Oneview, CED, CPF, Vipr,

Work Experience

Cigna Health Corp.

OneRX Pharmacy Supervisor Phoenix, AZ

Nov 2018 to Current

Manage team of call center associates to promote a working team environment and ensure best practices are shared.

Works to develop employee’s skills, evaluates performance and provides feedback.

Oversees resolution of employee relations issues and performance standards, productivity and service standards.

Conducts hiring, training, and evaluation of staff.

Tracks and periodically reports progress to management.

Ensure service levels and performance guarantees are met

Provide on-going coaching to each Customer Service Associate (CSA) on their team concerning quality, reliability, accountability and productivity.

Cigna Healthcare Corp. Phoenix, AZ

Quality Review/Audit Associate/Work@Home Aug 2017- Oct 2018

•Manage a team of 15 to 20 people every quarter reviewing calls to ensure that the appropriate quality is the outcome.

•Maintain feedback data base and tools.

•I support the developing process improvement plans and manages projects that support the improvement of the customer experience.

•Responsible for the delivery of customer experience impact through the quality program.

Cigna Healthcare Corp. Phoenix, AZ

Customer Service Representative/Work@Home July 2015- Aug

•Responsible for answering complex inbound member or provider calls regarding health plan benefits, claims status, authorization and health plan documents.

•Ability to handle calls without assistance

•Extensive knowledge of products, processes, and systems

•Serves as mentor for new employees

•Responsible for assisting with production of call center reports and ensuring call center metrics are met

•May assist with training initiatives

Banner Healthcare Medical Group Surprise, AZ

Patient Financial Services 2014-July 2015

Verify insurances for Family Practice and Pediatric appointments.

Review daily schedule for the following day appointment

Schedule appointments for 3 Family Practice and 2 Pediatric doctors when patients are checkout and when patients call.

Collect copays and deductibles owed for scheduled appointment

Review insurance information with patients

Verify patient demographics and obtain signatures from Patients on forms need to continue care at the facility

Loma Linda University Medical Center Loma Linda, CA

Customer Service Representative 2010 – Nov. 2012

Collected $20,000 dollars in liabilities and co pays in a month

Worked in a fast-paced environment delivering a required 8 minute service per patient to ensure a fast and efficient registration process

Recognized by management as the Most Efficient Team Member for seeing the most patients (30 patients) per day and delivering a stellar 5 minute service per patient

Received positive customer feedback via customer surveys regarding resolving payment arrangement problems

Served as the “Go-To” person answering staff members’ questions and requested by other managers to work in other departments such as the Children’s Hospital, Cancer Center, Pediatrics Specialties Center, Proton treatment and MRI

Loma Linda University HealthCare Loma Linda, CA

Insurance Verification Representative 2009 - 2010

Awarded “Employee of the Month”; verified Medi-Cal and Medicare; obtained authorizations and checked eligibility update patient demographics


Westwood College Torrance, CA

Certificate in Medical Billing May 2013 - Present

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