Customer Service Representative
Resume:
COVER LETTER
Tracy Waddles
Houston, Texas 77073
****************@*****.***
To Whom This May Concern:
I graduated with a bachelor’s degree in Business Administration from Strayer University in Atlanta Georgia. I have received my degree in Business Administration, with a concentration in Human Resources. My interest in this position stems from my belief that I have the right combination of relevant experience, communication skills and high levels of organization that I feel makes me a great candidate.
I feel some of my strongest abilities are:
Maintaining positive work environment
Implementation of recruiting programs to meet all departmental hiring requirements.
Creating user-friendly questionnaires to be used by the organization during staff recruitment and interviewing.
I am a dedicated, dependable individual who possess excellent verbal and written communication skills. I would like the opportunity to build a relationship with your company that would be mutually beneficial as my educational background, customer service experience and qualifications would make me a perfect fit for your Human Resources position. This opportunity would also allow me to refine my skills in a working environment.
I hope you will consider me for this position. I look forward to meeting you and discussing my qualifications in detail.
Sincerely,
Tracy Waddles
TRACY WADDLES
2415 High Island Way Houston, Texas 77073
251-***-**** · Phone
*******@*****.***
My goal is to become established in a position that will maximize my skills, utilize
my training, administrative skills, and development in the healthcare industry
EXPERIENCE
2021 – PRESENT
AMERIHEALTH INDEPENCE BLUE CROSS / BLUE SHIELD of PA
CUSTOMER SERVICES INSURANCE SPECIALIST
The customer service representative specialist is responsible for responding to a diverse membership and their providers as well as other customers in a timely, professional, and courteous manner. This includes inbound and outbound member and/or provider phone calls or correspondence regarding benefit, eligibility, claim processing, reprocessing, appeals along with any other customer issues. Makes outreach welcome calls to new members and conduct Health Risk Assessment Surveys as needed. Provides member education and assists members with PCP selection and assignments. Assists with access to care and wellness program. Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures. Create accurate and timely member documentation concerning all inquiries taken in accordance to established protocols to ensure resolution is provided and presented in a clear and accurate manner. Additional duties include insurance verification, being able to identify, communicate/articulate and understand the difference between insurance plans (HMO, PPO, EPO, etc.) Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide a better customer experience. A focus on center key performance indicators.
2000 – 2021
SSI GROUP, CLIENT SERVICES SUPPORT SPECIALIST SUPERVISOR
Health claims management, revenue cycle and call center processing, with increasing responsibility over operations and SSR support call volume along with implementing various process for the Western Region. Professional skillset which can immediately benefit any healthcare clearinghouse processing organization, with extensive on-the -job experience covering HIPPA compliances, current Governed CMS regulations, and current clearinghouse industry regulations. Extraordinary customer service and interpersonal skills, developed by working closely with colleagues. Possess the ability to understand the difference between insurance plans (HMO, PPO, EPO, etc.) Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide a better customer experience. Have vast knowledge of ambulatory care with requirements and necessary outpatient qualifications.
EDUCATION
MASTER’S IN BUSINESS ADMINISTRATION PROGRAM W/CONCENTRATION IN HUMAN RESOURCES: STRAYER UNIVERSITY (PENDING)
BACHELOR OF BUSINESS ADMINISTRATION W/CONCENTRATION IN HUMAN
RESOURCES MANAGEMENT, STRAYER UNIVERSITY 2016-2019
DEAN’S LIST GRADUATE 2016-2019
KAPPA DELTA PI NATIONAL HONOR SOCIETY
SKILLS
Lead Supervisor for Western Region
Dependable and punctual
Negotiation and conflict resolution abilities
COVID-19 Recovery
Flexibility
Excellent Customer Service
Public Speaking
LinkedIn Learning for: Operations Management
SOFTWARE KNOWLEDGE
Areas of Expertise:
Claims Adjudication HIPPA; Compliance Electronic Claims Processing Explanation of Benefits; Revenue Recycle Management; Claims Processing Software Clearinghouse/Gateway Services; Claims Management Access Management, Microsoft Office
Contact this candidate