Customer Service Data Entry

ELOISE MARIE WEST

*** ****** ***. **·Grand Rapids, MI 49534

***.******@*****.***·616-***-****

EXPERIENCE

****-**** ******* ***** ******, MI

Cashier

• Provide fast, friendly, and accurate guest checkouts 2019-2020 Marshalls Grand Rapids, MI

Merchandise Associate

• Assist customers in retail setting

• Stock and maintain merchandise for customer needs 2001-2018 Priority Health Managed Benefits Inc. Grand Rapids, MI Senior Customer Service Specialist

• Assist and educate members and providers of the health plan benefits, how to access services, and facilitate problem resolution in a pleasant and immediate manner.

• Efficiently respond to telephone and face-to-face inquiries from members, providers, and employers (customers) while meeting departmental standards.

• Courteously provide customers with information and education concerning benefit clarification, eligibility requirements, verification, and claim status.

• Facilitate claim resolution through follow up on member calls and correspondence interdepartmental or through direct contact with providers. Route claims and correspondence received in daily mail to appropriate departments.

• Effectively track all correspondence by entering complete documentation of issues and any related follow-up into computer system daily while successfully identifying potential trends or issues that impact health plan members and work with appropriate departments and/ or co-workers to implement changes or new procedures.

• Maintain knowledge of all product lines: HMO, POS, ASO, PPO, Medicare, and other products as they are developed. 1998-2001 Physicians Health Plan Muskegon, MI

Senior Customer Service Specialist

• Assist membership in resolving issues related to all aspects of health insurance.

• Educate membership on all product lines and multiple benefits.

• Resolve claim and pharmacy issues.

• Provide Customer Service to Medicaid and commercial memberships. Administrative Support

• Provide office support to Customer Service, Care Coordination, Network Services, and Government Programs.

1995- 1998 Shoreline Insurance Agency, INC. Muskegon, MI Customer Service Specialist

• Provide office support to licensed agents for life and health businesses

• Process new sales documents

• Provide customer service to insurance clients

1994-1995 Visiting Nurses Home Care Muskegon, MI

Clinical Secretary

• Responsible for data entry of recertification of physician orders.

• Purchased all medical supplies utilized by staff EDUCATION

Muskegon Community College Muskegon, MI

• Nursing

SKILLS

• Microsoft Windows

• Microsoft Word

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