Lanny R. Wilson Jr.

***** ****** ******* **.

Rancho Cucamonga, CA 91739

adzgxd@r.postjobfree.com

Home: 614-***-****

SUMMARY

I am a highly motivated and service-oriented Customer Service Representative with over ten years of experience in the healthcare and telecommunications industries. My skills include providing prompt and appropriate responses to inquiries via telephone, written correspondence, chat, and email. I have a demonstrated ability to work with internal and external resources to ensure first-call resolution and closure of all inquiries. I am experienced in documenting all quality and metrics reporting activities through Customer Relationship Management (CRM) applications. I possess strong analytical and problem-solving skills, with a talent for identifying trends that may lead to policy or process improvements.

EDUCATION

I am currently pursuing a bachelor's degree in Information Technology at the prestigious University of Phoenix, located in the city of Phoenix, Arizona.

PROFESSIONAL EXPERIENCE

Customer Service Rep. at Buckeye Health Plan in Columbus, Ohio, from 2020-2022.

I resolved customer inquiries promptly and appropriately via telephone and written correspondence. I worked with appropriate internal and external resources to provide first-call resolution and ensure closure of all inquiries. I documented all quality and metrics reporting activities through the Customer Relationship Management (CRM) application. I also routed processing inaccuracies in claim payments to the appropriate team for claim adjudication. I identified trends related to member and provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards.

Senior Customer Service Rep. at Healthcare Support in Columbus, Ohio, 2019-2020,

I provided first-call resolution by working with appropriate internal and external resources and ensuring all inquiries were closed. I processed written customer correspondence and delivered the right level of follow-up promptly. I identified trends related to provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards. I worked with other departments on cross-functional tasks and projects to improve the effectiveness and efficiency of customer service. I maintained performance and quality standards based on established call center metrics, including turn-around times.

Utilization Review Rep. at Aetna Healthcare in New Albany, Ohio, from 2014-2016,

I utilized clinical skills to coordinate, document, and communicate all utilization/benefit management program aspects. I processed clinical data, including receipt, data entry, verification, or filing of clinical information via inbound/outbound call and fax communication of clinical data and benefits information. I generated data queries based on validation checks or errors and omissions identified during data entry to resolve identified problems. I developed project-specific data management plans that address data coding, reporting, transfer, database locks, and workflow processes. I utilized analytical or scientific software provided by Milliman Care Guidelines.

Technical Support Representative at Dish Network in Hilliard, Ohio, 2008-2011;

I provided quality technical support through a one-call resolution to establish a long-term customer relationship. I accurately responded to questions and assisted customers (internal and external) with product features, installation, setup, troubleshooting, and hardware operations via chat, phone, and email. I assisted Technical Operations in determining call types, failure trending, and diagnostic improvements to provide higher technical support. I assisted in the training and development of new or Tier 1 staff. I worked as support staff for management, covering teams when the supervisor was out of the office.

Customer Service Representative/Scheduler at BioScrip in Columbus, Ohio, 2007-2008;

I processed one hundred patient calls daily. I placed refill orders or started new orders, checked the status of orders, resolved patient concerns, and provided price quotes. I made outbound calls to schedule delivery of medications at a rate of twenty calls per hour on average and made compliance calls. I performed other duties as requested.

Customer Service Associate (CSA) at Cigna Healthcare in Columbus, Ohio, 2003-2006;

I served inbound calls from participants, clients, and service providers. I processed fee adjustments, updated benefits and eligibility information, researched and analyzed consumer information, ensuring accuracy, and investigated and resolved claim payment errors. I consistently met and exceeded average handle time and quality of service standards. I received commendations monthly from clients and employers for the quality of service, resulting in additional vacation days, gift cards, and certificates of appreciation. I was selected to participate in a national pilot program to allow claims to be processed by CSA, transitioning the organization to a more customer-centric focus.

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