Customer Service Professional
Resume:
FRANCES DENISE DAVIS
CONTACT
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EMAIL:
******.*******@***.***
EDUCATION
Person Senior High School
Graduated 1978
WORK EXPERIENCE
BCBSNC
**/**/**** ** **/29/2017
Results-oriented Customer Service Professional and excelled at uncovering customer needs, finding solutions and handling objections accurately.
Top performer with a consistent track record of meeting and exceeding goals.
Supervisor who had 11 employees who corrected claims for our groups. My responsibilities included obtaining the claim issues from the group and giving them to the assigned employee for correction. I preformed audits on these employees to ensure their actions were correct. If the claim was handled incorrectly, I worked with the employee to ensure corrective action was taken. My teams were very successful.
Manager in Raleigh Network Management office where my team was responsible for all providers in the following counties: Durham, Wake, Orange, Person, Granville. I audited my staff on their daily duties as we also took ownership of any claim issues they were unable to get resolved to their satisfaction. These situations were also audited as we determined the error and why it was not readily resolved. We notified the respective areas as needed.
Worked in Membership/Small group where I enrolled members directly into Facets. My work was audited, and I had a 99% accuracy rate.
I have also processed claims manually, thru the LRSP system, PowerMHS s, I had a 98% error rate as I was subject to audit.
Manpower
09/01/2019 to 04/12/2023
Customer Service Professional who assisted our clients with Blue Connect and claim issues. If claim was incorrectly processed, sent these to be adjusted. Our work was also audited to ensure accuracy.
Membership added Coordination of Benefits information as submitted by Medicare or the member.
I have worked the following systems: LRSP, Macess, PowerMHS, and Facets.
Trained new employees with new on job processes.
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