Customer Services
Resume:
Ruth A. Rice
Phila, PA *****
************@*****.***
Summary: Enthusiastic customer service- support personnel with over 20 years
experience in the health insurance industry. Demonstrated effectiveness
handling multi tasks and developing strong internal and external customer
relations. Responding to departmental needs on short notice. Thrives in
an environment requiring serving customers, listening, learning and
Gathering data. Utilizes time management skills and is very dedicated.
8/22 Enhanced Recovery Company LLC Jacksonville, FL 32256
WFH Mortgage Customer Service Rep
• Partners closely to share best practices and product knowledge for previous mentioned areas, as well as connections, 3rd party services such as SkillSoft, & products or process implications affecting payroll and/or benefits administration.
• Assists with growth & development of service associates by identifying training and mentoring opportunities and assists with facilitating training.
• Participates in projects such as system rollouts & releases, client database spin and merges, client acquisitions, client system optimization, etc.
• Coordinates efforts between service teams & internal ADP business partners (HPS, BES, Tax & Finance, etc.) & external 3rd parties as needed.
• Aids overall client satisfaction by providing dedicated ownership of large, complex, value-added tasks and/or services requiring project coordination with tenured, skilled, and dedicated team resources.
• Works with internal business partners including sales, relationship managers, implementation, client services, and technical support to strategize best practices for project resolution and client system optimization.
4/22.- 8/22 Company Voice PA 19422
Customer Service Online Banking Specialist
Received Incoming Calls Log Complaints/Compliments Give Technical help with lockouts/resets for online banking Process payments/refund fees Compass (pop money).
Trained Co-Workers to be more efficient and teach them new programs by sitting with them for 1 hour at a time and training new reps in On Job Training.
Coordinated the fun at work team, plan and organize events month to month, scheduling meetings, give presentations at the meetings, managing monthly budget, completing expense reports, responsible for over 150 Co-Workers not including management.
Supervised internal employees during the clean-up project.
Worked closely with programmers to develop new online banking applications.
Answered incoming calls Assist customers with online banking Reset passwords Great
customer service and communication skills.
Resolved any issue involving Bill payments or system errors involving Online Banking
12/20 -4/22 The Carney Group Blue Bell, PA 19422
Customer Service Rep
Receive inbound calls from participants and providers with regards to plan benefits and claim status information
Answer participant/provider questions, as well as question callers to obtain full understanding of what assistance is needed
Document all calls accurately using call tracking system
Monitor call status for responses from other departments, as needed, so call returns are done in a timely fashion
Research caller’s issues/problems and find solutions
Follow-up with caller within a 24-hour period regarding the initial phone call, even if it is just to touch base and let caller know the inquiry is being researched
04/20 11/20 Angels On Call Home Care Philadelphia, PA 19046
Care Giver
Activities of Daily Living
Companionship
Walking and transferring
Bathing and showering
Personal grooming
Menu planning & meal preparation
Dressing assistance
Skin care
Helping with dietary constraints
Light Housekeeping
Vacuuming
Dusting and sweeping
Helping maintain an overall tidy home
Light Laundry
Dishes and kitchen clean up
Changing bed linens
Transportation & Errands
Doctor’s appointments
Grocery shopping
Personal care appointments
Errands
Leisure activities & entertainment
Additional Transportation & Travel
Companion Services
05/17 – 01/01/20 Tanya Family Day Care Sicklerville, NJ 08081
Receptionist
•Greeting customers
• Answer incoming and outgoing calls
•Scheduling
•Make sure Daycare is clean
•Data entry
•Follow up on phones and emails
•Administrative duties
•Handle payments
5/18-04/19 Children’s Hospital Philadelphia,PA 19107
Enrollment Specialist
Provides reviews and prepares new hire enrollment packets for accuracy, completeness and timely submission to the payers and maintains current provider information in order to ensure timely reimbursement of payment for services. Performs follow-up with the physicians to request necessary documentation for the application/re-credentialing process (Renewal reminders must be sent 30 days prior to the expiration date).
• Maintains a working knowledge of payers’ processes and updates and ensures that the physician database and NPPES system is kept accurate and current. CAQH re-attestation to occur every 120 days for all providers.
• Maintains files, scans credentials and monitors expiration dates and notifies administrators and Enrollment Manager of deadlines.
• Initiates phone calls, generates letters and other correspondence as required for follow up with payers to ensure timely receipt of provider participation effective dates and numbers (goal is within 60 days of payer receipt date of the application). Assures that all contacts and discussion with payers are documented and maintained, as well as copies of emails and/or written correspondence sent to third party payers, for future reference.
• Reviews and provides research results to the Billing Department to assist with claims issue resolution.
Additional Technical Requirements
Detail oriented, task oriented, problem solving and reasoning skills, works individually as well as in a team environment
Proficiency with MS Word, Power Point, Excel computer programs is required. Knowledge of the ECHO and CAQH system is preferred
2//18 -05/18 Medical Staffing
Enrollment Specialist
• Provides reviews and prepares new hire enrollment packets for accuracy, completeness and timely submission to the payers and maintains current provider information in order to ensure timely reimbursement of payment for services. Performs follow-up with the physicians to request necessary documentation for the application/re-credentialing process (Renewal reminders must be sent 30 days prior to the expiration date).
Maintains a working knowledge of payers' processes and updates and ensures that the physician database and NPPES system is kept accurate and current.
CAQH re-attestation to occur every 120 days for all providers.
• Maintains files, scans credentials and monitors expiration dates and notifies administrators and Enrollment Manager of deadlines.
• Initiates phone calls, generates letters and other correspondence as required for follow up with payers to ensure timely receipt of provider participation effective dates and numbers (goal is within 60 days of payer receipt date of the application). Assures that all contacts and discussion with payers are documented and maintained, as well as copies of emails and/or written correspondence sent to third party payers, for future reference. • Reviews and provides research results to the Billing Department to assist with claims issue resolution.
12/17- 04-18 Hr. & Block Philadelphia, Pa 19121
Receptionist
•Greeting clients in a personalized, friendly, and inviting manner
•Matching clients with the best-suited tax professional for their needs
•Scheduling clients how they would like to be scheduled
•Handling client exits by ensuring all current and future needs are met
•Maintaining office cleanliness and organization of resources with team member
•Other duties as assigned
•Answering all inbound calls
•Providing excellent customer service giving the proper information to consumers
•Data entry of consumer information
•Utilize phones, chat and email in order to respond to customers efficiently
•Some administrative duties
•Process payments
•Answer incoming and outgoing calls
9/17-11/17 Canon Business Process Services Philadelphia,Pa
HOSPITALITY CLERK - I
Set-up conference room for scheduled meetings
Disassemble conference room and store furniture and equipment
Organize and distribute supplies to client employees as detailed in job requests
Monitor inventory of equipment and supplies
Receive catering orders from vendors
Prepare food for delivery
Prepare food for delivery to conference rooms by placing on service carts
Food service setup in conference room as per order details
Ensure timely delivery of all catering orders.
Maintain neatness and cleanliness of all catering supplies and stocking locations/pantries
Clean and organize conference room by removing food and catering supplies
Clean table tops, phones and dry erase board
Additional responsibilities may include:
Receive, sort, and deliver all incoming mail & packages according to assigned floors and within established time frames.
Wrap, seal, weigh, affix postage and dispatch all outgoing mail/packages in accordance with postal regulations.
Prepare special outgoing inter-office pouches sent to client affiliates as scheduled (if applicable).
Package and process outgoing overnight items, i.e. Federal Express, UPS, etc., to meet client and vendor deadlines. Log and deliver incoming overnight packages within established time frames.
Log outgoing and incoming items as required and review for accuracy/completeness.
Clean, stock, and organize pantries with appropriate items.
Beverages for meetings / functions when needed.
Clean-up meeting spaces at conclusion of meeting
01/99- 1/17Aetna INC. Bluebell, PA 19046
Provider Data Services Analyst
Maintains the Provider Data (demographic and contractual) for all network and non-network providers.
Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (directory listings).
Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.
Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and / or data integrity issues.
Performs accurate and timely baseline demographic transaction updates in provider system applications in support claim adjudication and Doc Find.
Performs intake triage and responds to network inquiries
Provides on -going department support in research and analysis essential to resolving
Concerns /issues raised by providers and other internal/external customers.
Reviews provider maintenance requests for complete and accurate information
Contacts providers to clarify and resolve data quality issues.
Identifies and appropriately escalates data transaction issues that mightly potentially have significant contractual implications or adversely impact service levels.
Highly organized and able to quickly prioritize multiple assignments with high quality results.
Effective communication skills, both verbal and written.
Solid PC skills, including Microsoft Office products and internet navigation skills.
Working knowledge of EPDB, Mainframe, SCM, IOP View, and MCS.
Training:
Excel, PowerPoint, Word, Microsoft Outlook, Dos, DAF
Mainframe, EPDB, MCS, Claims Training, SCM and IOP.
Education:
Olney High School Phila, PA 1992
Community College Phila, PA 1996
Major: Computer Technology
References: Available upon request
Contact this candidate