Care Representative Customer Service
Resume:
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CONTACT
Seffner, FL *****
********@*****.***
SKILLS
Customer Service Excellence
First Call Resolution
Claims Processing
Data Analyzing
Documentation and reporting
Quality Assurance
Claims Validity
Call Direction
Professional Telephone Voice
Verbal and written communication
Customer support
Claims Payouts
Settlement Determinations
Service recommendations
Account management
Call center operations
Team Collaborations
REFERENCES
Available Upon Request
Service-focused professional bringing unparalleled skills in customer
relations, task prioritization & time management. Motivated to directly
& efficiently address customer concerns head on, develop proactive
solutions & implement corrections with efficiency. Service driven team
player with record of providing high-quality support.
WORK HISTORY
April 2020 to Current
Business Owner/Operator Bayzo, LLC, Tampa, FL
Oversaw end-to-end business processes to maintain proficiency and profitability.
Served as primary point-of-contact with customers to achieve client expectations.
Monitored staff performance, providing final-say assessment over inquiries.
Served as principal stakeholder over organization's complete operations.
Promoted positive atmosphere and went above and beyond to guarantee each customer received exceptional food and service.
March 2019 to Current
Claims Representative II Health Integrated Inc., An EXL Service, Tampa, FL
Offered advice and assistance to customers, paying attention to special needs or wants.
Proposed settlements for uncomplicated issues to resolve claims.
Generated, posted and attached information to claim files.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Prepared insurance claim forms or related documents and reviewed for completeness.
April 2018 to February 2019
Claims Representative I Health Integrated, Tampa, FL
Maintained consistent follow-up on status of prior authorization requests.
Interviewed policyholders to verify information and obtain additional details.
Verified by telephone or internet eligibility and benefits for third-party payer insurance from information provided on patient registration form.
Tracked referral submission during facilitation of prior authorization issuance.
Worked productively in fast-moving work environment to process large volumes of claims.
August 2015 to April 2018
Customer Care Representative Health Integrated, Tampa, FL
Coordinated timely responses to online customer communication and researched complex issues.
Responded to customer needs through competent customer service and prompt problem-solving.
Logged call information and solutions provided into internal database.
Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Assisted call-in customers with questions and orders.
EDUCATION
High School Diploma
Brandon High School, Brandon, FL
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BELAAN BROWN
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