Customer Service Representative

DANIELLE DELA MERCED

** *** ****** ***** * Troy, NY 12180 518-***-**** adylhw@r.postjobfree.com PROFESSIONAL PROFILE

Customer service-oriented professional who ensures smooth patient flow by providing prompt attention to pulling patient charts and necessary medical records, gathering accurate billing and financial information, and reviewing intake materials for accuracy and completeness.

Function independently with minimal direction and guidance

Adapts to new challenges and ideas and able to develop relationships with diverse populations

Remain flexible and prepared to adapt to various situations

Microsoft Office Applications / MS Excel MS Word MS PowerPoint KEY QUALIFICATIONS

Payment Posting Scheduling HIPAA Compliance Medical Billing CMS 1450 (UB-04) CMS 1500 Insurance Verification Insurance Claim Processing EOBs Co-Payments Deductibles Medical Terminology Medicare Medicaid Tricare Managed Care (HMO PPO POS) Government Payers Third Party Payers Workers Compensation Medical Coding ICD-9 ICD-10 HCPCS CPT Fee Schedules Electronic Health Records (EHR) EDUCATION

Ultimate Medical Academy Associate of Science Degree - Medical Billing and Coding, 2019 PROFESSIONAL WORK EXPERIENCE

Eddy Memorial Geriatric Center – Troy, NY 05/2021 – 08/2021 Certified Nursing Assistant

Provided quality care for elderly patients' including, but not limited to dressing, bathing, and feeding

Assisted in moving/repositioning bedridden patients as to prevent pressure ulcers and bed sores

Monitored patients' mental and emotional conditions and well-being

Reported and recorded any changes and care provided

Consistently worked with patients to assess and develop their ADLs and meet their individual care plan goals BlueCross BlueShield – Troy, NY 02/2020 – 04/2020

Utilization Management Representative

Took incoming calls, built cases, and checked diagnostic and CPT codes

Entered data into company system in an accurate manner

Effectively communicated all information with customer Maximus Call Center – Albany, NY 09/2019 – 01/2020 Customer Service Representative

Handled incoming calls from consumers including the public and prospective enrollees

Tracked and documented all inquiries using the applicable systems

Took incoming calls from consumers and providers requesting information about the Medicaid

Met quality assurance and other key performance metrics

Facilitated the fulfillment of caller requests for materials via mail, email, and downloads Gyro House – Mesa, AZ 08/2015 – 09/2015

Short Order Cook / Customer Service

Performed a multitude of tasks including food production and serving customers

Ensured operation excellence by adhering to systems and standards of the store

Worked in a team environment and communicated effectively with managers and co-workers Danielle Pope (Cont.)

Hancock Fabrics – Charlotte, NC 02/2008 – 07/2008

Team Lead / Customer Service / Cashier

Processed transactions, accepted payments, and provided prompt, courteous customer service

Answered phones, trained new employees and prepared daily deposits

Supervised 5 employees, handled customer complaints and completed end-of-day paperwork

Set up displays, dispensed inventory and built positive employee relationships Start Corporation Call Center – Rock Hill, SC 06/2005 – 06/2006 Customer Service Representative

Interacted with customers via inbound calls to resolve customer inquiries

Took action and followed up to ensure timely and efficient problem resolution

Entered customer data in an accurate and thorough manner

Communicated in a clear and concise manner and worked effectively as a team member VOLUNTEER EXPERIENCE

Humane Society – York, SC 04/2000 – 09/2000

Dog Walker

Monitored and looked after pets

Handled situations with grace and respect

Provided other services such as walking and playtime

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