Service Representative Insurance Customer

Shayla S. Moore

**** ****** ****** *****, ** ****4

Cell Phone: 402-***-****

Professional strengths

Possess excellent communication skills, both verbal and written

Familiar with the principles and procedures of business management

Possess strong organizational skills

Goal-oriented and ability to handle multiple tasks

Ability to type 50 words per minute accurately

Possess excellent phone etiquette and interpersonal skills

Dependable, reliable, and goal oriented

Ability to learn new tasks quickly

Strong analytical and organization skills

Ability to work in a fast paced, team environment

Technical skills

Knowledge of basic operating systems like Microsoft Outlook, Word, PowerPoint, Excel and the internet

Familiar with software operating systems like Windows XP

Work Experience

April 2022-Current Signature Performance/ Signature Choice

Conducts every transaction with a customer focused, courteous, approach that will ensure first call resolution and achieve provider satisfaction scores of 90% or higher. Acts with an ownership mentality by researching and evaluating accounts for proper adjudication. Proficient with key systems such as, Fee Basis Claims System (FBCS), VistA, and the Claims Processing & Eligibility (CP&E) system. Communicate effectively by documenting call activity into VA systems. Maintaining access for all assigned client systems and making those around you better by being an effective team member and advocate

June 2021- April 2022 Kindred at Home, Omaha, NE United States

Patient Schedule Coordinator: As a scheduler, I update and maintain the daily schedules for 2 of the 3 teams of patients (200+) and clinicians (25) in the office. I also keep in constant contact with my supervisor and the clinicians in the field of any changes needed or executed. Other duties as assigned include: running office meetings for the daily reports, running payroll report once a week, assist in inputting patient information, etc.

November 2019- March 2021 Centene Corporation- Nebraska Total Care, Omaha, NE United States

Quality Assurance Specialist I: As a QA Specialist, I ensure that all calls are being executed correctly and timely by extracting audio, grading audio and presenting call reviews. I also nurture trainees until sign off with mentor emails on information that needs to be corrected and congratulating them on accomplishments during this time.

March 2016- November 2019 Direct Patient Logistics, Omaha, NE, United States

Quality Assurance Specialist

October 2014-November 2019 Direct Call, Omaha, NE, United States –

Patient Transfer Coordinator: As a PTC, I proficiently and accurately perform the duties of coordinating and facilitating patient requests with attending medical staff to assure the best medical care is provided and patient needs are adequately met. Also I maintain a high level of customer satisfaction with patients, physicians, and other medical staff.

December 2013-October 2014 Convergys, Omaha, NE, United States

Travelers Insurance Customer Service Representative - Travelers Insurance Quality Assurance

Education

September 2006 – May 2014

University of Nebraska at Omaha, Omaha, NE, United States Degree: Bachelor of General Studies- Criminal Justice (May 2014)

January 2005 – August 2006, December 2011

Metropolitan Community College, Omaha, NE, United States

September 2002 – May 2006

Omaha North High, Omaha, NE, United States

Areas of Interest Traveling, playing violin, karaoke, listening to music

References available upon request

Contact this candidate