Customer Service Agent
Resume:
NyTalia Petestone
I am available for immediate remote work
Dallas, TX 75216
*********@*****.***
I possess 25+ years of customer service experience, 6 years call center, and 3 years remote work. Providing the best Customer Service experience is my focus. Authorized to work in the US for any employer
Work Experience
Benefits Outsourcing Specialist-Remote Contractor
Willis Towers Watson - Richardson, TX
July 2022 to Present
• Assisting employees with Medical, Dental, Vision and Life insurance benefit options for their families during the Annual Enrollment season.
• Providing ample Customer service practices pertaining to questions regarding benefit plans for pre/ post retirement pensions.
Community Outreach Specialist-Remote Contractor
Centauri Health Solutions - Litchfield Park, AZ
October 2021 to December 2021
• Determined Medicare Advantage eligibility for adults 65 years and older.
• 100-200 Inbound/Outbound calls pertaining to outreach services for food, clothing, and housing.
• Troubleshooting members concerns regarding their medical accounts.
• Medicare/Medicaid enrollment processes.
Customer Care Representative II - Remote
LCP Transportation LLC - Indianapolis, IN
October 2019 to April 2021
• Promptly scheduling transportation to and from medical appointments for both Caresource and MHS members.
• Revising, Canceling, Verifying, member trips both urgent care one-way and non-emergent.
• Dispatching company vendors as well as TCS drivers regarding departure and arrival times for members.
• Troubleshooting and educating both Caresource and MHS members on LCP transportation policies and procedures.
• Verifying both Caresource and MHS member medical eligibility with the state of Indiana as well as HIPAA.
Environmental Specialist I
IU Health Methodist Hospital Emergency Department - Indianapolis, IN April 2019 to January 2020
• Aide in hospital patient services, prepare hospital rooms for new patient admittance in ICU, emergency department, and additional rooms throughout the hospital.
• Also preparation of daily patient services in the Wound trauma clinic. Eligibility Specialist-Contractor
Department of Family and Social Services - Indianapolis, IN August 2017 to October 2018
• Processed applications for Medicaid/Medicare and SNAP/TANF benefits.
• Verified documentation for eligibility purposes.
• Scheduled interviews for benefits and re-certs.
3rd Shift Lead
CVS Health - Indianapolis, IN
December 2017 to June 2018
• Worked as a cashier/stocker/merchandiser 8 days on and 6 days off.
• Supervised the entire front end of the store from 10p-7a. Troubleshooted customer inquiries, engaged in helping customers with their individual needs.
• Processed money orders, money gram, returns and exchanges. Customer Service Agent II - Remote
United Telemanagement Corporation - Dayton, OH
April 2016 to June 2017
• Work from home position answering calls for new clients wanting caregiving services.
• Clocked caregivers in and out of their shifts.
• Responded to chats for new service intakes.
• Activated TV/Phone services for patients in hospitals within MI, NJ and NY areas. • CC processing and pre-authorizations.
Customer Service Associate I- Contractor
Caresource - Dayton, OH
September 2015 to December 2016
• Answered calls, to verify Medicaid/Medicare eligibility for new members.
• Health benefits for new members, signed members up for marketplace and Just 4 Me healthcare services.
• Researched provider information for members and scheduled appointments.
• Data entry, appointment setting for medical transportation services.
• Mailed new insurance cards to members.
Education
Current- Associate Degree in Behavioral Health Science RioSalado College - Tempe, AZ
October 2020 to Present
Trade School in Medical Billing and Coding
Everest University - Gahanna, OH
June 2008 to August 2010
General Education Diploma in Education
Meadowdale High School - Dayton, OH
September 1995 to June 1998
Skills
• Dispatching (1 year)
• Office experience (10+ years)
• Typing (10+ years)
• Microsoft Word (10+ years)
• Ices Systems (1 year)
• Microsoft Outlook (10+ years)
• Computer Systems (10+ years)
• State Eligibility Systems (3 years)
• Mile Systems (1 year)
• Cisco Systems (1 year)
• HIPAA Certification (5 years)
• Call center (6 years)
• Customer service (10+ years)
• Typing (10+ years)
• Medical Coding (2 years)
• Behavioral Health-Student (2 years)
• Hospital Experience (1 year)
• Medical Scheduling (1 year)
• Medical Terminology (5 years)
• Medical Billing (3 years)
• Sales (10+ years)
• Microsoft Office (10+ years)
• Customer service (10+ years)
• Phone etiquette (10+ years)
• Medicare (6 years)
• Medical records (1 year)
• ICD-9 (2 years)
• Insurance verification (6 years)
• CPT coding (2 years)
• Salesforce (1 year)
• Epic (1 year)
• Troubleshooting (10+ years)
• DUO (2 years)
• Dayforce (1 year)
• Documentation review
• Microsoft Access
• Customer support
• Windows
• Analysis skills
Languages
• English - Expert
Awards
Sales Award
April 2012
Awarded Top 5 in District Sales for Aarons furniture sales within first 6 months of being hired. Certifications and Licenses
HIPAA Certification
October 2021 to Present
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