Service Representative Call Center
Resume:
CEMONAY NEWELL
*** **** ********* ******* * Lewisville, TX 75067 l 773-***-**** l ********@*****.***
Career Objective
I want to obtain an entry level position in my field of studies that builds upon and utilizes my collegiate, internship and community experiences and activities.
Key Skills
Excellent analytical skills
Cooperative team member
Outstanding interpersonal skills
Computer proficient
Quick learner
Microsoft Office, Excel, PowerPoint proficiency
Strong verbal communication
Collaborative team member
Issue resolution
Energetic and organized
Experience
Amerisource Bergen- Roanoke, TX January 2021 to May 2022
Patient Service Representative
Demonstrate flexibility and adapt to changes in payer, pharmacy and patient assistance program processes and requirements
Establish relationships with assigned clinic staff, pharmacy and hospital contacts, and keep them informed of patients’ status and payer challenges
Provide integrated services to health system and its component parts to increase prescription capture rate, improve patient outcomes and reduce readmissions
Communicate patient and provider feedback to PHS management to enhance process improvement
to enhance continuity of care
Provides temporary coverage to support clients and patients in the event of onsite resource absences
Performs additional related duties as assigned
Conifer Health Solutions- Frisco TX January 2020 to February 2021
Enrollment Services
Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed.
Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions
Access payer websites and discern pertinent data to resolve accounts
Utilize all available job aids provided for appropriateness in Patient Accounting processes
Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account
Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities
Provide support for team members that may be absent or backlogged
Cardinal Health - Lewisville, TX October 2017 to December 2019
Sr. Care Coordinator
Creates and completes accurate applications for enrollment with a sense of urgency.
Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted.
Serve as a liaison between client sales force and applicable party.
● Support team with call overflow and intake when needed.
Researching insurance coverage for Medical and Pharmacy coverage
Applies advanced skills to resolve complex problems independently
May modify process to resolve situations
Works independently within established procedures; may receive general guidance on new assignments
May provide general guidance or technical assistance to less experienced team members
Lash Group - Dallas, TX November 2016 to October 2017
Benefits Specialist
Verified patient eligibility and claim status; maintained strict patient and physician confidentiality.
Review and document prior authorization process, claims, etc.
● Electronic verification of pharmacy coverage for patients.
● Collect and review all patient insurance information needed to verify accounts.
Teleperformance Call Center, Edinburg TX February 2014 – November 2016
Comcast Wireless Gateway Technical Support
Greet customers in a courteous, friendly, and professional manner using agreed upon procedures.
Listen attentively to customer needs and concerns, demonstrate empathy.
Confirm customer understanding of the solution and provide additional customer education as needed.
Communicate effectively with individuals/team in the program to ensure high quality and timely manner of customer requests.
Prepare complete and accurate work and update customer file.
Effectively transfer misdirected customer requests to an appropriate party.
Probe for and confirm understanding of requirements or problems
Convergys Call Center, Pharr, TX
Sept 2013 – Nov 2013
Sales & Service Associate
Greet customers in a courteous, friendly, and professional manner using agreed upon procedures.
Listen attentively to customer needs and concerns, demonstrate empathy.
Confirm customer understanding of the solution and provide additional customer education as needed.
Communicate effectively with individuals/team in the program to ensure high quality and timely manner of customer requests.
Prepare complete and accurate work and update customer file.
Effectively transfer misdirected customer requests to an appropriate party.
Probe for and confirm understanding of requirements or problems.
Education
University of Texas Pan American
2010-2013
Major: BS -General Studies Minors: Sociology, Kinesiology and Rehabilitation
Tyler Junior College
2008-2010
Major: Associates Degree - General Studies
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