Customer Service Human Resources

Benita A Myers

**** **** ******** *** *********, FL 33578

813-***-**** (C)

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

Career Objectives

Seeking full-time position offering advancement in a progressive company.

I feel a technical background through education along with experience will

enable me to seek a position of management in the future.

Education

J.P. McCaskey High School (1986 Graduated)

Studies included: Business Classes and General Education

Job Experience

Elevance Health, Simply Healthcare Plans - Tampa, FL 06/2022-Present

Healthcare Promotions Rep I

Responsible for providing initial contact between Care Management programs and specific identified members. Under direct supervision handle inbound and outbound enrollment and engagement calls with eligible members to provide information regarding program features. Primary duties may include, but not limited to;

Meet with Providers for Hedis measures to provide solutions to fill gaps for preventative visits ie: well care, immunizations, diabetic care, high blood pressure, to name a few.

Schedule meetings with providers Hedis Care Coordinator at their convenience either every month or bimonthly depending on their scoring rates.

Organize clinic session to meet and greet members when appointment is made on specific clinic session day to meet and greet and answer any questions or concerns that they may have or to provide information in which may be needed.

Also, to assist with eligibility issues, to obtain verify demographic information. Provide give aways to members that are seen for their preventative visits.

Upload schedules and member demographics to be called by outreach coordinators to schedule appointments for different provider groups.

handle own provider groups (list of own clients) that are assigned, or I have reached out to inquire if they would like to work with Simply in getting members scheduled and seen by provider.

Research group information or member information for eligibility with Medicaid

Ashton Carter - (Contractor for Aerotek-Anthem) Tampa, FL 10/2021-06/2022

Support plan initiatives to target member population thus decrease HEDIS care gaps. Assist members in care coordination with network providers.

Coordinate appointments to capture HEDIS care gaps. Proficient use of Microsoft Excel, Teams and SharePoint.

Responsible for providing initial contact between distinct Care Management programs and specific identified members. Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features.

Primary duties may include but are not limited to Records call details and utilize call scripts as needed based on client requirements.

Directs member inquiries to appropriate clinical staff.

Contacts physician offices to obtain demographic information or related data as needed.

Member outreach, scheduling for preventive visits, HEDIS care gaps, facilitating access to care.

One Touch Direct- (Contractor for ID.Me) Tampa FL 06/2021-7/2021

Provide timely, accurate, and efficient service to our customers via email and/ or video chat Verify member identification and follow verification procedures.

Work with other customers to troubleshoot verification issues and provide a working solution Assist in documentation and playbook updates as necessary.

Inktel- (Contractor for Coca Cola Florida) Tampa Fl 05/2020-04/2021

E-COMM Sales Customer Care Rep

Handle email inquiries for customers inquiring about online issues, dealing with accounts. Place Coca Cola Orders for delivery, via; email, inbound calls.

Handle inquiries for Cruise line ships and placing orders for Cruise line ships, business', schools, restaurants, military, amusement parks, hotels, and incarceration facilities.

Take inbound calls and place outbound calls.

Follow up calls and emails to inquiries from customers. Handle invoicing of orders.

Handle chat over internet with customer that use online chat for assistance.

Handle issues with accounts for customers who need assistance with resetting passwords for online ordering accounts.

Place Service tickets when a technician is needed for equipment service.

Place Sales tickets to Sales Area Rep when assistance is needed for customer needing a Sales Rep to contact Customer or a onsite visit is needed.

Assist other co-workers with issues that may arise.

Maximus Federal- Riverview, FL 03/2020- 05/2020

Customer Service Rep

Handled Medicare inquiries from Beneficiaries, questions or concerns about claims or billing of account with Medicare Part A, Part B or Part D (Prescription plans) to include Medicare Advantage Plans.

Offer assistance with Medicare Advantage Plans or other services to include Extra Help, low-income Subsidy.

Offer, assistance with other organizations to tailor Beneficiaries needs through an Agent Partner Search Program.

Assist with Claims, Durable Medical Equipment inquiries, as well as, ordering replacement cards, entitlement letters and appeals.

Follow proper protocols with personal information and getting full disclosure of Beneficiary information not to disclose information to incorrect person that isn't authorized on account.

Authorized callers with Beneficiary on phone to be able to speak to person other than Beneficiary. Transfer calls to proper department when needed.

Optum360 United Healthcare Tampa, FL 05/2019-03/2020

Customer Service Rep

Handle various high volume calls in a call center Answer questions pertaining to services and billing Take payments for lab services.

Calls from insurance providers to include questions with billing and settlements Calls from medical providers to update diagnosis information for re-billing Update insurance information for patients to correct billing.

Send out demand bills for patients copy or PIF bills for patient records Correspondences through email or faxes.

Update demographics per patient request

Update collection information or stop/holds for collections Rebill and adjust claims as necessary.

Progressive Insurance Riverview FL 10/2016-03/2019

Customer Service Consultant

Handles inquiries and transactions for a single line of business.

Identifies the customer's motive for calling and understands the customer's insurance needs Adds and deletes vehicles, drivers and coverage from existing policies.

Processes cancellations, renewals, reinstatements, endorsements, payments, and state/federal filings on Progressive systems.

Advocates for and educates on Progressive's systems.

Uses software applications to track, gather information, and answer inquiries. Applications to also include Microsoft office series, outlook, instant messenger (skype for business)

Office machines: fax machines, copiers, printers, scanners to upload documents to policies computers and telephone for correspondence.

Arrange mailings to go out through UPS or United States Postal Service. Via, overnight or standard mail. Remains flexible to better meet the needs of the customer; including faxing needed documents to dealerships, lienholder’s, Dept of Motor Vehicles to said states that customers reside or formally resided Stays current on products, services and procedures.

Remains flexible to better meet the needs of the customer.

WAWA Corp- Tampa FL 12/2012-10/2016

Fresh Food Manager

Actively manages and oversees the duties of running a shift including coaching.

Making sure all associates are working safely and efficiently engaging customers, helping with special requests.

Cashiering of consumers products for check out, collecting and dispersing correct change back to consumer.

Handling cash transactions as well as maintaining ad reconciling all safes Lottery Machine and reconciling money tills.

Checking in and out of Vendors

Ordering for supplies for, grocery items, deli and beverage areas

Also, in charge of cycle counts for different areas of store for accounting of store bought and store use items.

Contact with Human Resources and other departments and sister operating stores of WAWA via; Microsoft Office e-mail (outlook), phone, mail to include overnight of credit card receipts, petroleum receipts as well as employee paperwork that were to be submitted to human resources.

Fax through Microsoft outlook, print off schedules or plan-o-gram job aids for store employees from office copier.

Ordered ink for copier when also needed the upkeep of the printer/ copier Development of new and existing associates.

Upkeep of deli and beverage areas with cleaning and if need; call to call center for maintenance or vendor to repair.

United Travel Services- Tampa FL 10/2012 (no longer doing business)

Customer Service Rep

Notifying Customers of the travel packages

Explaining what they are receiving and verifying all information for shipment out to customer.

Volunteered for son's Progress Village Baseball Team and Spoto High School Navy ROTC 01/2010- 06/2012

TAMPA GENERAL Health Park Health Clinic- Tampa, FL 4/2008-12/2010

Patient Access Specialist

Interview patients to obtain all necessary account information over telephone Pre-Reg patients for appointments with OB/GYN clinic.

Called providers if script referrals or authorization numbers were needed.

Called patients if their assistance is needed for getting necessary paperwork for appointment.

Notified medical records of duplicate account/chart numbers for patients or if certain charts were needed to be pulled.

so that information needed to be obtained or research certain information if needed Cancelled appointments, if necessary, documents weren't received.

Answered patients phone calls when they had concerns about their appointments or if patient was returning.

a call that was placed to them and a voicemail was left Verified insurance benefits.

Assigned correct insurance I-plans to account when registering patient.

Brandon Regional Hospital- Brandon, FL 10/2005-04/2008

ER Registrar/Discharge Cashier

Interview patients to obtain all necessary account information Ensure charts are completed and accurate.

Verify all insurance and obtain authorization.

Calculate and collect patient liable amounts when discharged at cashier booth Ensure that all necessary signatures are obtained for treatments.

Answer any questions and explain policies clearly.

Receive and receipt payments from patient for services rendered. Prepare daily deposits and maintains the integrity of the cash drawer.

Work with physician offices and ancillary departments, providing information when necessary or forwarding relevant documents via scanned to patients’ chart also to close out patient chart at time of discharge to be filed back with medical records.

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