Service Representative Customer

Maliah Woodruff

**** ********** ***** ● Sacramento, CA 95842

916-***-**** ● **************@*****.***

EDUCATION

Visions in Education, Carmichael, CA Graduated: 2017

• GPA 3.6

• AP courses English, Biology, and History

QUALIFICATIONS

Intelligent, efficient, dependable, and quick to learn new skills

Resourceful, persistent, and driven to succeed

Able to maintain calm under pressure and quickly resolve customer issues

Detailed oriented with the ability to multitask

SKILLS

• Microsoft Office (2007-2010)

• Word, Excel, PowerPoint

• 55 WPM

• 11,100 Ten key

• Good verbal and written communication skills

• Excellent phone skills

• HIPPA Certified

• Omni 1 & 2

• Maces

• ABS

• Pega

• Unity

• True Care

• Filenet

• OCOE

EXPERIENCE

North Coast Medical Supply – Physician Support Specialist. September 2021- Current

Communicate with doctor’s offices by phone, fax, email and/or mail correspondences to pursue prescription orders and/or required medical records to ship a patient's order.

Provides excellent customer service while communicating with provider offices and teammates.

High Call Volume per day (approximately 65-100 inbound and outbound calls combined per day)

Consistently obtain a high percentage of valid prescription orders based on the number of quality outbound calls attempted.

Maintains accurate records in company database.

Review documents retrieved from inbound faxes to determine validity; scan documents efficiently and accurately.

(estimated 100 documents per day)

Manage assigned outlook inbox to correspond with appropriate teammates.

Perform any additional responsibilities or special projects as required.

GAINWELL TECHNOLOGY PROVIDER SERVICES MEDI-CAL PROVIDERS. July 2020 - March 2021

• Handle high production Inbound calls for provider service

• Provider claim status for Beneficiary

• Medi Medi cross over claims

• Cal POS pharmacy rejection claims

• Check writes status to verify last check paid to providers

• Procedure code look up for providers to verify if claim will be paid

• Provider Appeals status clarification on paid or denied claims

• TAR Approval request verification

• Maintain records and files and documentation as appropriate

• Meet production and quality standard in a timely manner

Centene Healthnet Insurance : Costumer Service Representative September 2019- March 2020

●Assisting over the telephone to Medicare supplement and medi-cal members and providers with excellent costumer service

●Providing benefits and eligibility

●EOB adjudication, payment collection, post payments to patients ledger

●Disenrollment, claim status, appeals and grievances,

●Medical and pharmacy authorization status

● Updating members billing and mailing addresses, Primary care physician and medical group transfers, and verifying contracted providers in network.

Bel Air Grocery Store: Courtesy Clerk July 27, 2016- August 2018

●Providing Excellent Customer service.

●Running Self check out and over riding the registers when they malfunction.

●Assisting customers with groceries such as bagging and taking them to the customers vehicle.

●Maintain the store shelves and arranging product, maintain cleaning of restrooms and checkout counters

Woodruff Construction/ Reliable: Assistant June 2018- August 2019

●Scheduling appointments for clients estimates.

●Provide direction/assistance for any problems that may arise with customers, management, construction, and outside vendors.

●Process payments and deposits from client work orders

●Creating and distributing customer receipts and contracts.

●Assist in typing up and distributing work orders and scheduling of staff and keeping track of employees payroll hours.

Contact this candidate