Customer Service Representative
Resume:
Cheryl L. Jones
Columbia, South Carolina 29203
adq1pr@r.postjobfree.com
Completed studies in accounting and business management to go along with many years of firsthand experience with managing food services, retail and kept track of payroll and inventory. When required to also completed counts on sales and made deposits to the bank. Working in a call center environment have completed tasks such as enrollment of medical coverage, explanation of status of claims processing while abiding by HIPPA guidelines and in other instances troubleshot cellular and satellite networks for technical support. Have worked with Microsoft Office and I am versed in using all aspects of it to complete the job. Work Experience
Customer Service Associate
Hornet Staffing
March 2022 to April 2022
In training to receive faxes and inbound calls from providers and billers to determine if requested service requires authorization or additional medical documentation. Customer Service Specialist
VDart Accenture
May 2021 to October 2021
After completed training took inbound calls for Maryland Department of Unemployment to assist claimants on the status of received unemployment benefits. Assisted claimants with certifying for weekly benefits over the phone when unable to complete individually. Answered questions about the change of status when benefits would be placed on hold or cancelled. Provided information on requirements to stay eligible for benefits, how to change options to receive payments and educated claimants on steps needed to submit an appeal for denial of payments.
Customer Service Specialist III
Kelly’s Services
August 2019 to April 2020
Once in classroom training was fulfilled took inbound calls from Medicare Advantage and Part D policy holders. Processed monthly premium payments, provided clarification on the status of claims processed, submitted requests for appeals on denied claims and prepared requests of documentation from treating doctors so prior authorizations, formulary exceptions and cost saving tiering exceptions could be submitted for approval. Concierge Specialist
Anthem
August 2018 to May 2019
After completed training took incoming calls from patients and providers to give claim status, appeal rights of denied claims, amount billed by and paid to facilities per claim in question. Shift Manager
Bojangles
March 2018 to August 2018
I supervised scheduled shift to prepare for opening shift of breakfast. Delegated crew to required positions to begin preparation of food items ordered. When needed covered open positions such as biscuit making, taking and totaling orders with register and prepared money from previous day’s sales for bank deposit.
Customer Service Representative
WNS
February 2017 to January 2018
Once training was finished, was able to reference a knowledge base to maintain phone logs, answer questions about status of billing and took an average of 50 to 60 calls per day for a Pennsylvania power company. Assisted with collecting payments for amounts due and took reports about power outages when they occurred. Completed problem tickets using ticketing system to notify of new outages as well. Customer Service Representative
Aerotek
March 2016 to November 2016
After successful completion of in class training took 40 to 50 inbound calls daily to assist policy holders with questions on insurance policies and annuities. Sent out requested forms for withdrawal requests, 1035 exchanges and changes to policies. Submitted requests for lapsed policies for reinstatement when requested.
Customer Service Representative
Teleperformance
January 2015 to February 2016
Completion of in class training to be familiar with using a knowledge-based system ensuring that appropriate changes were made to resolve customer concerns. Took 60 to 70 calls per day. Required to also do tele-sales to recommend improvements in packages, services received and billing methods to prevent future problems and enhance the viewing experience of the customer.
Customer Service Specialist
Medbridge Home Medical
June 2013 to June 2014
Took 40 to 50 calls per day from customers who were interested in enrolling into advantage plans provided by Medicare. Verified if customer qualifies for coverage and took information to determine best plan to fit customer’s needs. Also offered prescribed DME supplies needed so caller can remain compliant with medical treatment. Confirmed information using HIPPA guidelines and maintained a level of privacy for each member’s information obtained. Customer Service Representative
Palmetto G.B.A.
May 2007 to August 2012
Processed 70 to 80 calls per day from providers of Medicare to given them information on why submitted claims denied and what can be adjusted to allow the claim to process. Verified if Medicare coverage is allowed to pay and confirmed physician information according to HIPPA guidelines.
Substitute Teacher
Richland County District One
May 2006 to April 2007
Through online database signed up to cover classes for absent instructors. Followed prepared lesson plan left by sitting teacher. Filled for instructors who taught kindergarten through eighth grade.
Shift Manager
Arby’s
June 2005 to May 2006
Completed morning drops from previous day’s sales at established bank and performed count of inventory and waste in the store. Delegated crew to necessary positions to optimize speed of service and make sure orders were completed and issued out to customer satisfaction. Customer Service Representative
Gallman personnel
December 2004 to May 2005
Placed on temporary assignment to prepare reports for route packs used by delivery drivers. Completed required filing, typing, and covered answering the phones when needed. Also processed data entry to retrieve and update customer information. Customer Service Specialist
Kelly’s services
January 2004 to December 2004
During open enrollment of Medicare Drug coverage enrollment took up to 100 calls daily to assist with verifying the appropriate drug card for customers based on prescribed medications currently taken. At the beginning of each call verified HIPPA before releasing any information and sent out information packets of discussed plans for member to review and make a final decision.
Education
Associates of Business Management
South University in Columbia, South Carolina
June 2014
Enrolled and completed required courses that included Accounting, Business Ethics, Human Resources, Marketing, Economics and Finance for completion. Diploma
Eau Claire High School in Columbia, South Carolina June 1992
Each year enrolled in Honors courses to complete required to complete requirements. Enrolled in NJROTC where I graduated at the company commander. Also participated in the Debate Team for extra curricular activities.
Skills
• Teamwork
• Computers
• Management
• Supervision
• Customer Service Satisfaction
• Medicare
• Insurance verification
• HIPAA
• Technical support
• ICD-10
• Relationship management
• Business Management
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