Service Representative Appointment Setter

Antoinette Spencer

Cell: 832-***-****/Home:832-***-****

Email: *****************@*******.***

Summary:

Customer Service Representative HEALTH INSURANCE offering excellent communication, listening and critical thinking skills. Able to drive positive customer experiences by promoting customer-centric behaviors and actions, evaluating customer needs, and implementing product and service solutions to enhance customer loyalty. Excellent Customer Service.

Experience:

12/6/2021-PRESENT

CUSTOMER SERVICE REPRESENTATIVE: CLAIMS/SUPERIORHEALTHPLAN

ANSWERED INCOMING CALLS FROM PROVIDERS RE: CLAIMS

RESEARCH CLAIMS DENIAL: CPT CODES, TMHP, ICD10

CHECKED PROVIDER CREDENTIALLY FOR UPDATES

ESCALATED CLAIMS OVER 30-DAY TURN ARROUNDS.

PROVIDED INFORMATION ON PAYORS ID.

APPEALS STATUS., RECONSIDERATION ON CLAIMS

2/1/21-11/5/21

PECO-

ANSWERED INCOMING CALLS

PROVIDE INFORMATION ON THE ACCTS OF THE UTILITY COMPANY

OFFERING THE CUSTOMER INFORMATION ON DIFFERENT GOVERNMENT AGENCY OFFERING ASSISTANCE.

HELP TO SET UP PAYMENT PLANS FOR CUSTOMER.

TAKING PAYMENTS ONLINE.

RESTORING SERVICES TO CALLER DISCONNECTED.

10/05/2019-2020

CUSTOMER ADVOCATE-TELETECH-BENEITS

Answered incoming call re:

MEDICAL COVERAGE, HELPIING CUSTOMER WITH THE DIFFERENT PLANS.

HELPING TO LOCATE PROVIDERS, PHARMACY, CLINC WITHIN THEIR PLANS.

EDUCATING THE CUSTOMER ON BEING FAMILIAR WITH THEIR PLAN CHOOSING FACILITIES IN THEIR NETWORK, VERSUS OUTSIDE NETWORK,

BENEFIT COVERAGE

PRE-AUTHORIZATIONS

UPDATE DATES TO THE SYSTEM.

APPEALS

ADJUSTMENT

NICE

Concierge- The Auberge – Houston, TX

Answering phones and accepting appropriate information or messages.

Greeting visitors and directing inquiries.

Accepting initial inquiry information

Providing marketing tours and arranging marketing meals, as appropriate.

Maintaining records of inquiries for future phone follow-ups or mailings.

Placing following marketing calls to prospective clients, as directed by manager.

02/2014 to Current

Direct Caregiver -Just Real Kare Houston, Texas

Observed and documented patient status.

Charted patient complaints to the case manager.

Read and recorded temperature, pulse and respiration.

Massaged patients and applied preparations and treatments, such as liniment, alcohol rubs and heat-lamp stimulation.

Completed and submitted clinical documentation in accordance with agency guidelines.

Assisted with adequate nutrition and fluid intake.

Planned, prepared and served meals and snacks according to prescribed diets.

11/2018 to 02/2019

Customer Services- Sykes Home Solutions Galloway, OH

Answered customers' questions and addressed problems and complaints in person and via phone.

Processed up to 20 customer orders per day.

Collaborated with customer service team members to give exceptional service throughout the entire shopping and purchasing experience.

Built customer confidence by actively listening to concerns and giving appropriate feedback.

02/2016 to 06/2017

Healthcare Provider- Amada Senior Care The Woodlands, Tx

Cleaned and organized patients’ living quarters.

Positioned residents for comfort and to prevent skin pressure problems.

Assisted with transferring residents in and out of wheelchairs and adaptive equipment.

03/2009-8/2010

Appointment Setter-Church Services- Houston, TX

Completed forms in accordance with company procedures.

Maintain scheduling and event calendars.

Provide services to customer such as order placement or account

Discuss all new promotions occurring at that time,

06/2008 – 12/2008

Employment Processor- Eagle Global Logistic-Houston, TX

Used various database to do background checks, driving records, drug test on all new drivers.

Answered incoming calls to direct to appropriate employees,

Operated office equipment such as fax machine, copier, phone systems.

08/2003 to 04/2006

Annual Enrollment of Benefits -Hewitt and Associates- The Woodlands

Create and maintain, and enter informat8ion in databases

Setup; and manage paper or electronic filing systems, recording information, updating paperwork.

Complete forms in accordance with company procedures.

Provide services to customers, such as order placement or account information.

Education:

Bryman Education-Houston, TX

Medical Assistant

Graduate: 1983

Professional Career Institute-Houston, Tx

Medical Billing and Coding

Graduate: 2013

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