Data Entry Call Center
Resume:
Hello,
I’m Erica Nganku, SENIOR CUSTOMER CARE REPRESENTATIVE
Houston, TX
**********@*****.***
My Objective
My objective is to obtain a career that will offer me the opportunity for growth and progress; and likewise the opening to utilize the skills and training I have developed during my years in the job field. I am looking for a company that is dedicated to enhancing the knowledge and experiences of its associates.
Experience
JUL 2022 - CURRENT
Texas Children’s Hospital, REMOTE - Pro r Se c / Mem S r i s ETeam Inc. **************@********.***
● Serves as a Member and/or Provider Advocate by possessing knowledge and understanding of the organization's processes, policies and procedures in order to investigate, resolve and/or facilitate resolution of simple to moderately complex issues and/or questions reported by Texas Children's Health Plan (TCHP) members, prospective members, healthcare providers, or other entities relating to TCHP Managed Care Organization.
● Being the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals and/or any other Member/Provider needs.
● Assists and advocates for Members and/or Providers throughout the complaint and appeal process.
● Assists Members with timely appointment scheduling. Responsibility A: Supports the Health Plan call center’s day to day operations.
● Handles calls from Members/Providers seeking assistance with Member and/or Provider related issues.
● Reviews systems to identify issues, comprehensively researches the issues, collaborates with other departments, communicates with internal and external resources, and creates appropriate responses.
● Acts as a liaison and advocate for the Members/Providers.
● Gathering information to support decisions or recommendations for action needed to resolve Member/Provider questions, issues, and/or concerns.
● Assists with real-time resource management.
● Interacts tactfully and empathetically with Members/Providers.
● Ensures HIPAA protections are in place by verifying the identity of all callers prior to disclosing Personal Health Information (PHI).
● Completes all assigned work queue tasks and/or after hour call center vendor notifications.
● Completes necessary documentation thoroughly, accurately, and timely in TCHP or TCH systems e.g. MACESS or EPIC when applicable.
● Alerts team leader of any issues or concerns that require escalation for complete resolution or which may indicate a larger underlying problem. JAN 2022- JUL 2022
Aston Carter/ Intermountain Healthcare R1, REMOTE - C Aston Carter. 801-***-****
● Prepares, formats and cleans data in order to provide appropriate data for future utilization and analysis.
● Performs data entry functions by hand-keying electronic information into various data systems in order to maintain updated information for future use and analysis.
● Updates spreadsheets and data systems with updated content in order to maintain accurate information.
● Develops queries in order to filter appropriate data.
● Copies data from source files to destination files to ensure alignment of information between various systems.
● Performs quality control audits by verifying the accuracy of entered data in order to ensure the integrity, completeness and proper usage of systems and data.
● Manage all incoming and outgoing calls.
● Resolve patient billing concerns.
● Respond to patient calls and emails.
● Answer questions regarding patient accounts.
● Manage payment plans with patients.
● Collaborates with leadership and staff to review and reconcile reports.
● Assists in problem solving and troubleshooting specific system issues in order to ensure appropriate functionality and data output.
● Performs general administrative duties such as scanning paperwork, file storage, printing and updating and maintaining departmental distribution lists. OCT 2021 - JAN 2022
NLB Services INC./ Cognizant, REMOTE - C
Next Level Business Services INC. 904-***-****
● High-call-volume Inbound contact center.
● Agents will be servicing providers calling to discuss member enrollment status and benefits for multiple carriers under the Allied umbrella.
● Answer incoming calls from patients, caregivers, branches and patient referral sources regarding nutrition therapy order status.
● Verifying patient demographics and insurance information to ensure accurate shipment.
● Challenge your healthcare training or current customer services skills to make a difference in a patient’s life by explaining by initiating the referral process and answering questions from patients and caregivers on their admissions status. OCT 2021- JAN 2022
AmerisourceBergen/ Lash Group, REMOTE - Ben fi V rifi on Spe is Spectraforce 919-***-****
● Reviews all patient insurance information needed to complete the benefit verification process in RX.
● Triages cases with missing information to appropriate program associates.
● Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options.
● Identifies any restrictions and details on how to expedite patient access.
● Could include documenting and initiating prior authorization process, claims appeals, etc.
● Completes quality review of work as part of finalizing product.
● Reports any reimbursement trends/delays to management.
● Performs related duties and special projects as assigned. APR 2021 - OCT 2021
Peachtree Service Experts, Duluth - C
Hire Dynamics 678-***-****
● Answers incoming phone calls from customers and assists the call or routes the call to the appropriate person.
● Maintains good customer relations and ensures that all calls meet Service Experts’ standards.
● Handles and resolves a variety of customer concerns, complaints, and questions by phone, email, chat, (questions may include billing inquiries technician ETA, scheduling issues, and general company product and service questions).
● Resolves problems by clarifying issues, researching, exploring answers/alternative solutions, implementing solutions, and escalating unresolved issues.
● Maintains customer records by updating account information.
● Accurately dispositions calls in call monitoring software.
● Adheres to CPI compliance regulations when taking payments over the phone.
● Updates capacity planner whenever calls are booked, rescheduled or canceled.
● Works with Sales and Service Coordinator to improve accuracy in scheduling and speed of response.
● Communicates with customers on the status of service calls.
● Assists with dispatching as needed.
● Continually maintains working knowledge of all company products, services, and promotions.
● Reliable attendance and on-time job performance.
● Performs similar/other duties as needed or assigned. NOV 2020 - APR 2021
COCC Online Banking, REMOTE - Cla Sp i s
Robert Half Agency 770-***-****
● Computer-assisted legal research
● Handle any client disputes in regards to bank account issues.
● Deliver information solutions that drive productive, efficient decisions.
● Password resets
● Online bank unlocks
● Allows online payment extensions.
● Responsible for reviewing a client's claim in chronological order.
● Provides enterprise-wide information needed.
● Process customer deposits, cash checks, issue official checks. NOV 2020 - APR 2021
Connaisseur Paris, Atlanta - Sal r / St is
Alain Chaps 404-***-****
● Dealings with custom Italian and French suits in all areas.
● Tailoring services
● Wedding wardrobe preparations
● Sets fitting appointments
● Takes online customer orders.
● Creates custom suits with a plethora of fabrics.
● Complete transactions on the register
● All around floor services for customers including serving champagne for top of the line experience.
● Maintain a clean store and environment.
● Handle changes in policies or renewal.
● Fitting clients and getting measurements for unique customized pieces. SEPT 2020 - NOV 2020
Aaron’s Furniture Club, REMOTE - Cla Sp i s
Robert Half Agency 770-***-****
● Computer-assisted legal research
● Deliver information solutions that drive productive and efficient decisions. ● Reviews natural disaster claims
● Reviews theft claims
● Allows Unemployment extensions
● Responsible for reviewing a client's claim in chronological order.
● Determine whether or not they are covered under a policy.
● Evaluate the extent of a settlement that the insurance company must pay. ● Provides enterprise-wide information needed.
● Revise and edit information receipts.
● Review company policies with local Aaron’s stores in regards to the customer’s unique claim.
JUN 2020 - SEP 2020
Louis Vuitton, Atlanta - BO pe on
Store number404-***-****
● Maximize product gift wrapping performance.
● Elevated customer satisfaction
● Leading Back-Of-House team throughout gift wrapping procedures, relabeling, as well as restocking the store.
● Demonstrate superb leadership skills in relation to dealing with high-end products.
● Willingness to overcome issues in a high scaled and fast paced, timely manner.
● Providing access to changing rooms
● Offer specialty treatment, and recommend and highlight merchandise.
● Assists with placement of orders.
● Suggest solutions when a product malfunction.
● Handle changes in policies or renewal.
● Answer questions about warranties or terms of sale.
● Works with the customer service manager to ensure proper customer service is being delivered.
JUN 2020 - SEPT 2020
LexisNexis, Alpharetta - Ope on
Robert Half Agency 770-***-****
● Creating visualizations of data using EXCEL
● Create reports for internal teams and/or external clients.
● Collaborate with team members to collect and analyze data.
● Use graphs, infographics and other methods to visualize data.
● Handling large amounts of encrypted data hourly
● Structure large data sets to find usable information.
● Computer-assisted legal research.
● Deliver information solutions that drive productive, efficient decisions.
● Provides enterprise-wide information needed.
● Revise and edit information receipts.
NOV 2019 - JUN 2020
Delta Dental, Alpharetta - C
Robert Half Agency 770-***-****
● Offer a variety of dental benefit plans to customers.
● Able to set up laptop, headphones, microphones, Skype, or any other chat client service to converse with customers.
● Managed representative calls with Non-English speakers with language interpreters seeking the proper dental insurance plan.
● Targeting areas of the mouth for tooth specific plans & specialties.
● Skilled with identifying all parts of the mouth.
● Account restoration/ password updates
APR 2019 - NOV 2019
Kaiser Permanente, Duluth - C
Insight Global 713-***-****
● Kaiser Permanente insurance plans from $150-$2000+ in value.
● Recommended Kaiser members to various facilities around their service area.
● Quoted providers subscriber benefits and eligibility statuses.
● Medicare & Medicaid plans
● Catered to regions such as Northern and Southern California, Mid
● Atlantic, North West, Colorado, Georgia and Hawaii.
● Handle 100+ customer interactions per day, giving detailed, personalized, friendly & polite service to ensure customer retention.
● Build customer loyalty by placing 100% customer satisfaction.
● Account restoration/ password updates
Education
AUG 2021- CURRENT
El Centro College - Associate of Science
Seeking forth my Criminology Major and Real Estate Minor. Key Qualifications
● Customer orientation
● Professionalism
● Dependability
● Reliability
● Communication skills
● Trainable
● Willingness to learn
● Efficient
● Self-motivation
● Customer orientation
● Troubleshooting
● Computer software savvy
● Abilities with time performance
● Cross-training members
● Ability to de-escalate situations
● Written, verbal communication
Contact this candidate