Service Representative Customer

*******@*****.***

Mukiya Dambreville

Charlotte, NC 28213

781-***-**** *******@*****.***

To obtain a position that can utilize my strong customer service and organizational skills. Top-performing, quality-driven, and a consummate professional with a willingness to learn, specializing in filing and maintaining files. Track record of excellence in leading, training and mentoring staff. Expertly manage office and administrative operations, effective and articulate communicator with ability to establish rapport with individuals at all levels.

Key Strengths Include:

• Attention to detail

• Well Organized

• Office Administration

• Communication Skills

• Customer Oriented

• Highly Motivated

• Team - Player

• Safety / Security

• Bilingual in English and French Creole

• Phone center experience

Professional Experience

NaviHealth, Charlotte (via Tennessee), NC (AUG 2022 - PRESENT)

Central Support Operations Coordinator

• Manage inbound and outbound telephone communication in a professional manner and according to productivity and quality standards.

• Process inbound and outbound data and communication (i.e. faxes, emails and electronic communication) according to productivity and quality standards.

• Enter, review and or verify member information in the NaviHealth Coordinate care management platform and communicate approved pertinent information with healthcare providers and/or NaviHealth team as needed.

• Enter the required data into the NaviHealth database accurately and in a timely manner.

• Complete administrative documentation for member records including but not limited to disenrollment, transitioning, creating authorization shells, attaching documents (i.e. medical records), and logging therapy information.

• Assist in a smooth coordination of members care between health providers and the health plan.

• Establish relationships and communicate, when appropriate, to providers, clients and/or NaviHealth field/care management staff as defined by departmental policy and process.

• Triage inbound calls manage member inquiries/requests, and resolve or escalates to appropriate naviHealth or health plan personnel.

• Adhere to organizational, departmental, compliance and regulatory policies and procedures.

WestMed, Charlotte, NC (AUG 2015 - AUG 2022)

Billing Clerical Associate

• Perform a variety of routine clerical functions such as filling, photocopying, faxing, etc.

• Collect, separate and distribute correspondence.

• Handle tasks of transmitting electronic claims, gathering and distributing electronic claims reports, maintaining logs, posting patient payments, completing insurance forms, assisting with insurance calls.

• Answer telephone, screen calls, take messages and address issues specifically trained to address.

• Assist in care and maintenance of department equipment (printers, photocopiers) and supplies.

• Correspondence with Law Offices and Insurance agencies to deliver Billing Records.

Aerotek (AmerisourseBergen Consulting Services) Charlotte, NC (OCT 2014 – JAN 2015)

Site Coordinator

• Verify benefits with various national insurance companies

• Trained on Healthcare Essentials and Records and Management (RIM)

• Submitted Benefit Investigation Forms (BIF)

• Review coverage and payment for Medicare, Medicaid and private payers across relevant sites of service, and addressed inbound inquiries regarding the billing, coding and claims submission process

• Confirming the payer has received the claim and providing any additional information the payer may need; facilitate the prior authorization process on behalf of patients to the degree allowed by the payer.

Novant Health Heart & Vascular Institute, Matthews, NC (NOV 2008- FEB 2012)

Patient Services Coordinator

• Managed and checked in clients for in and out processing.

• Scheduled appointments

• Verified insurance / precertification

• Ordered Supplies necessary for office operations

• Sorted and distributed routine correspondence

• Proficient in word processing software and printing devices to produce letters and reports

• Collected co-payments / posted charges

• Provided information to visitors and telephone callers

Time Warner Cable, Charlotte, NC SEP 2007- NOV 2008)

Customer Service Representative

• Provide customer service by phone and correspondence

• Properly assist in troubleshooting and scheduling service calls as needed

• Respond to billing questions, correct billing or discrepancies by phone

• Maintain acceptable sales performance in selling all services

• Practice service retention skills through probing to determine customer’s interest

Harvard University Health Services, Cambridge, MA (SEP 2001 – JUL 2007)

Medical Secretary

• Handled patient concerns and inquires

• Scheduled appointments

• Performed administrative duties

• Distributed mail

• Telephone triage

• Order supplies

Education

• Central Piedmont Community College (CPCC) Charlotte NC

Certificate, Medical Billing and Coding (May 2013-2014)

• Central Piedmont Community College (CPCC) Charlotte NC

Certificate, Medical Reimbursement Specialist (Nov 2012- 2013)

• Roxbury Community College (RCC) Roxbury MA

Certified in Patient Accounts/Administration (Sep 2000)

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