Service Representative Customer

JONIFER FERGUSON

*******.********@*****.*** 832-***-**** Pearland, TX 77581

Summary

Motivational Quality Coordinator with background in team management and quality control analysis. Expert at formulating effective strategies to improve performance. Successful at regulating and testing products to meet compliance requirements following quality control measures.

Skills

Customer Service

Complex Problem Solving

Product Inspections

Performance Monitoring

Experience

Quality Coordinator Village Medical Centers - Pearland, TX 01/2022 - Current

Crafted quality control tests to analyze data for process improvement initiatives.

Implemented internal auditing practices to create standards and statutory obligation compliance reports.

Collaborated with other team members to perform internal QA audits.

Made sure each product met industry regulations and standards.

Verfication Specialist Search Solution Group - Pearland, TX 11/2020 - 12/2021

Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.

Updated patient and insurance data and input changes into company computer system.

Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.

Accessed third-party insurance databases to identify coverage of benefits.

Examined claims, records and procedures to grant approval of coverage.

Checked documentation for appropriate coding, catching errors and making revisions.

Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.

Contacted patients to confirm demographic information and communicate financial responsibilities.

Entered data in EMR database to record payer, authorization requirements and coverage limitations.

Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.

Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.

Retained strong medical terminology understanding in effort to better comprehend procedures.

Handled billing related activities focused on medical specialties.

Customer Service Representative Sprint - Houston, TX 02/2013 - 05/2017

Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.

Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.

Answered inbound calls, chats and emails to facilitate customer service.

Remained calm and professional in stressful circumstances and effectively diffused tense situations.

Demonstrated excellent communication skills in resolving product and consumer complaints.

Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.

De-escalated problematic customer concerns, maintaining calm, friendly demeanor.

Consulted with customers to resolve service and billing issues.

Education and Training

Hightower High School Missouri City, TX 06/2009

High School Diploma

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