Benefits Representative Customer Service

DENICE BROWN BECKFORD

*****.******@*****.*** 757-***-**** Miami, Florida 33172

Summary

Over 10 years of successful experience in Customer Service with recognized strengths in problem-solving, conflict resolution, researching and planning. Serves customers effectively with attention to detail and hardworking approach. Reliable team member. Focused on going above and beyond to support team and serve customers. Dedicated to business success.

Skills

Proficient in Microsoft Access, Word, Excel, PowerPoint, and Outlook

Typing 55 wpm, and 10/key touch

Excellent organizational and time management skills

Cross-Functional Team Development

Experience in Leadership.

Fluent in Spanish and English

Active Listening

Experience

ARCADIA SOLUTIONS Boston, MA

Remote Health Claim Representative

10/2022—Currently

HUMANA HEALTH Miramar, Florida

Remote Inbound Contacts Representative II

08/2019 - 07/2022

Actively researching issues to adjudicate claims.

Facilitates the resolution of claims issues, including incorrectly paid claims and extracting data from CMS

Responds to incoming calls from providers regarding claims inquiries and document calls and interactions.

Research tracers, adjustments and re-submission of claims, referral, and authorizations.

Handle updates of PCP and verify eligibility.

Assisted customers via email, phone and chats in English and Spanish in anything related the status of the product.

Conducted training and support to new team members.

Processed customer orders and collected payment information.

Maintained customer interaction and activity records in CRM system.

Demonstrated exceptional service skills by consistently going above and beyond to ensure customer satisfaction.

Contributed as an escalation point for team members assisting with customers claims.

CONDUENT Chesapeake, VA

Senior Customer Service Benefits representative

01/2018 - 07/2019

Conducted improvement projects in conjunction with the training and develop department.

Generated daily stats report.

Responsible of taking escalation calls.

Monitored and evaluate service interactions to ensure quality base on service expectations.

Performed other duties as assigned and modified at manager’s discretion.

Bilingual Customer Service Benefits representative

09/2017 - 01/2018

Answered high volume English and Spanish incoming calls concerning Annual Enrollment, health Benefits and Billing questions.

Managed all technical request related to website issues.

Verified Claims and appeals related to health benefits.

NET Security Online CR San Jose, CR

Credit Analyst Manager

10/2007 - 03/2017

Act as main point of contact to approve or deny credit limits based on customer’s overall credit worthiness.

Assisted with preparing daily reports and communication pertaining to any adjustments to customer’s credit limits.

Make decisions regarding credit hold releases.

Provided guidance to the collection specialist regarding past due scenarios.

Compiled reports and information related data from internet or third-party platforms.

Bet Cris Sports San Jose, Costa Rica

Customer Service Manager

04/2003 - 09/2007

Supervised a small team of 50 employees.

Monitored team performance indicators to ensure quality of interactions are meeting standards.

Resolved escalated incidents from customer service agents

Helped interview and train new agents.

Designed support team needs based on key metrics and performance indicators.

Directed and facilitates team meetings.

BET MAKER San Jose, Costa Rica

Senior Customer Service Supervisor

11/1998 - 03/2003

Monitored inbound and Outbound calls and assist team with all escalation’s calls

Boosted team activities and performance metrics.

Ensured that staff meets goals and provide reliable, efficient support for customers.

Collaborated on continuous improvement of processes and training.

Educational Background

Florida Technical College

Certified Insurance & Coding Specialist

09/2022

Universidad Federada de Costa Rica

Bachelor’s in legal studies

03/2007

Trainings

Completed professional development in KM feedback Approver Training.

Metrics and Reporting Analysis Interpretation.

Coaching methods.

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