DE-LANA
SHELTON
Open to opportunities
CONTACT
PHONE:
EMAIL:
*.********@******.***
HOBBIES
Family
Crafting
Hiking
Nature
EDUCATION
Belford high School
2007
3.75 GPA
High School diploma
WORK EXPERIENCE
Tarkett
July 29, 2019 – December 23, 2021
Regional Customer Service Representative
Resolve customer inquiries, including but not limited to order status, product information, order processing, account status, sales programs, as well as product line knowledge
Maintain small to medium accounts with low-medium complexity Process all customer orders received by: EDI, telephone, fax, email, and mail for Tarkett through order entry system (SAP) efficiently and error free
Resolve complex and escalated customer issues, received via phone or email, with little intervention from Team Leads Review Delivery Due List (ZVL10C) for all customer orders in all plants to align with delivery requests
Daily contact with cross functional team: Executive Sales Manager/Field Sales Representative/ Marketing/Production as to customer order status
Answer any customer inquiries (fax, phone, email and mail). Check stock, provide availability dates, provide freight quotes once processed through the Logistics Department, refer public to Tarkett distributors in their area, or to the Tarkett website Ship samples as required by customers for product specials Collaborate with other company departments such as billing, credit, freight and transportation to solve customer inquiries Locate out-of-stock material for customers when required from other distributors Requirements.
Excellent interpersonal and communication skills – Email and phone etiquette
Ability to work effectively with cross-functional departments Commitment to company values, Strong customer orientation, detailed, problem solving.
MS Office proficiency
Ability to read and interpret documents such as procedure manuals, work instructions, software manuals
Assisted with customer disputes, deductions, and credits resolution
Navigating retail customer portals to obtain claims of shortages, late shipment, defective merchandise and incorrect pricing, or deductions for rebates and allowances as well as track claims for other customer types which do not have portals.
Coordinate with accounts receivable, customer service and sales support personnel regarding these claims and deductions to make sure we have proper documentation to substantiate claims or deductions or to prove that claims are not substantiated. Where not substantiated, dispute claims in customers’ portals. Where substantiated, issue credits.
Record all credit memos and disputes with credit reason codes in Company files and do monthly reporting of credits to distribute to upper management.
Collect new customer credit references and distribute updates to Sales personnel regarding status of credit applications. Necessary. Assist with entry of purchase orders to vendors as necessary Maintain the integrity of confidential business and product information.
Assist with training of new hires
Create training modules and PowerPoint with step-by-step training instruction.
Cigna
September 28, 2015 – 07/25/2019
Intake Senior Representative -
Provided initial customer contact for incoming calls. Perform outbound calls to hospitals and doctors’ offices to obtain additional information needed to certify cases.
Accessed automated case system to open document cases. Collect and provide data entry of case information.
Performed certification using scripted guidelines. Work as back- up for other associates when they are absent.
Determined covered medical insurance losses by studying provisions of policy or certificate.
Established proof of loss by studying medical documentation; assembled additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
Documented medical claims actions by completing forms, reports, logs, and records.
Resolved medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
Ensured legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
Provided legal support by assembling documentation for settlement action.
Protected operations by keeping claims information confidential. Prepared reports by collecting, analyzing, and summarizing information.
Accomplished organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments. Skills and Qualifications:
Claims Adjustment, Documentation Skills, Data Entry Skills, Analyzing Information, Problem Solving, Verbal Communication, Customer Focus, FDA Health Regulations, General Math Skills, Statistical Analysis, Medical Terminology, Medical Coding, HIPPA, EMR Records, UR Discharge Callouts & clinical reviews, Familiar with Cigna insurance plans and coverages, In and out of network benefits and coverages, HSA Accounts and deductibles. Convergys
06/11 - 04/03/2013
Customer Service Specialist/New Hire Transition Team Lead
Develop Staff. Training. Coaching.
Support Staff. Handle escalations. Provide answers and guidance to staff.
Be a manager. Lead and inspire. Communicate company news. Do Admin. Leave approvals. Payroll information.
Self-Development. Attend briefings.
Other. Take overflow calls.
Collaborates with telesales management to build and maintain the telesales quality monitoring scorecard
Completes regular call quality monitoring
Leads group coaching and call calibration sessions to ensure consistency
Identify opportunities to enhance key sales metrics Analyzes call quality data using tools such as Excel or internal systems to identify trends
Proactively identifying customer needs and solutions May coordinate/lead projects for call quality improvements Ability to partner and build relationships with internal and external teams
Adhere to regulatory requirements in applicable areas Provide insight on agent call patterns, customer behavior and market trends
Identify opportunities to enhance key sales metrics Able to summarize key areas of development to training department
SKILLS:
Self-development, Team development, Strategic thinking and acting, Ethical practice and civic-mindedness and innovation. Claims Adjustment, Documentation Skills, Data Entry Skills, Analyzing Information, Problem Solving, Verbal Communication, Customer Focus, FDA Health Regulations, General Math Skills, Statistical Analysis, Medical Terminology, Medical Coding, HIPPA, EMR Records, UR Discharge Callouts & clinical reviews, Familiar with Cigna insurance plans and coverages, In and out of network benefits and coverages, HSA Accounts and deductibles. Excellent attention to detail
Ability to type at least 55+ words per minute
Experience with exposure to SAP, or equivalent.
Experience with Workday and ADP platforms.