Customer Service Representative
Resume:
Damaris Harvey
ST. CLOUD, FL 34772
Cell: 414-***-****
Email:*.********@*****.***
Objective
Former Customer Service Representative and Benefits Coordinator with strong customer service skills, analytical skills, and good communication skills seeking a fulltime position in Customer Service area with opportunities for growth, training, & where my extensive experience will be further developed in a successful team setting.
Exceedent-Froedtert Health
Enrollment /Claims Analyst 9/2021-4/2023
•Responsible for updating employee coordination of benefit information into employee profile & data base
•Inform members of insurance policy guidelines
•Assist with claims processing
• Address any questions of concerns about COB to members.
•Save, scan, email, fax any documentation regarding COB.
•Proficient understanding of benefits regulations, policies, and procedures
•Mail COB forms to members in a timely manner
Exceedent- Froedtert Health
Customer Service Rep 06/2021-9/2021
Qualifications:
•Strong phone administration, active listening capabilities, & problem-solving skills
•Ability to work independently and as a team player
•Strong attention to detail
•Exceptional communication
•Ability to multi-task, prioritize, and control time effectively
Job Duties:
•Assist members with questions and concerns on of employee benefits
•Identify and evaluate customers' needs to deliver satisfaction
•Build sustainable relationships of trust through open and interactive discussion
•Provide accurate, valid and comprehensive information by using the tools & resources
•Manage complaints, provide proper solutions and follow up with secure resolution
•Keep records of customer interactions, process customer accounts, file, scan, & email documents
•Follow communication procedures, guidelines, and policies
Aurora Health Care- Billing
Customer Care Rep I -06/2020-6/2021
To address and research telephone and written inquiries regarding patient accounts.
Investigates and responds to all phone and written inquiries from insurance companies, physician offices, government agencies, and third parties in regards to medical account billing.
Works with other departments to resolve questions and issues related to billing, coding, and claim denials.
Researches account issues, generates required changes, establishes patient payment plans & processes patient payments.
Answers inbound calls and responds to high volume in call center environment.
Takes action to addressing and explaining necessary information from billing to medical records system including claims inquiry and, account history,
Meltric Corporation –Customer Service & Sales Support
Customer Service: 09/2017-06/2020
Process routine customer orders and other transactions like returns, credits, quotes, etc.
Service and assist with sales calls and offer product knowledge or technical support
Set up new customer accounts
Resolve and escalate customer issues and complaints
Prepared monthly statistical reports for department managers
Work with other manufacturing employees to determine availability on inventory
United Healthcare Group-Retirement and Medicare
Customer Service Claims Processor: 05/2016-12/2016
Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
Own problem through to resolution on behalf of the customer in real time
Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
Wacker Neuson Logistics
Product Support &Sales Agent: 06/ 2012 -04/2016
Effectively up sell existing customer orders
Manage assigned Utility and Power product groups
Process routine customer orders and transactions
Resolve and escalate customer issues and complaints
Service and assist with sales and product knowledge
Froedert & Medical College- Clinical Research Coordinator I: 9/2004-6/2007
Assist in coordinating studies by preparing personnel and materials, preparation of protocols, informed consents, amendments and other necessary documents for review by the IRB and Sponsor.
Assemble lab kits and/or gather supplies.
Collect and label samples as instructed and deliver or process samples in accordance with the protocol, manual of operations, standard operating procedure (SOP) or other work instruction set.
Follow direction of clinical research coordinator or others involved in the clinical research project work. Assist other staff members and coordinators to implement studies.
Maintain inventory of supplies, tools, & equipment for asthma Study
Identify regulatory activities to be completed and takes the initiative to complete.
Coordinate and participate in the assembly of materials.
Assist in maintaining up-to-date and accurate written and electronic records and files to support clinical research activities.
Assist with audit readiness records review and preparation activities.
Assist with maintaining protocol specific SOP's, IRB and regulatory correspondence.
Demonstrate an awareness of federal regulations; state and local law; GCP/ICH and CCHMC policies to promote ethical practices in research involving human participants and to ensure compliance to those regulations.
Recognize the importance of reporting concerns of ethical and/or regulatory issues to supervisor in a timely manner.
Seek out research educational opportunities.
Maintain awareness of status of all active studies.
Identify potentially eligible participants.
Coordinate, plan and execute study visits and provide instructions and reimbursement to participants.
Approach potential participants and families in a professional manner.
Conduct pre-consent screening procedures according to protocol specifications to determine eligibility.
Execute the informed consent process according to Good Clinical Practices (GCP), CCHMC procedures and other applicable policies.
Communicate with participants' clinical team regarding study participation as indicated by protocol and/or manual of operations.
Communicate challenges with recruitment and retention to the study leadership.
Assist with organizing and filing all correspondence.
Participate in meetings, discussions and activities designed to improve organizational performance through recommending areas or approaches for improving study conduct.
Complete Case Report Forms (CRFs) and source documentation in compliance with all applicable guidelines for human research.
Education
Wauwatosa East High School: Wauwatosa, WI 1994-1998 (High School Education-Diploma)
Waukesha Technical College: Waukesha, WI 2013-2014 (Microsoft Office Program: Excel, PowerPoint, &Word MRA
(Effective Communications Course Creative Customer Problem Solving Course)
Milwaukee Area Technical College: Milwaukee, WI 1998-2000 (Experience in the following Programs: SAP, CPS, CRM, Microsoft Word, Outlook, Excel, Access, and EPIC.)
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