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Customer Service Representative

Location:
Baltimore, MD
Posted:
September 21, 2023

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Resume:

CUSTOMER SERVICE REPRESENTATIVE

ANTONIA RICH

Reliable & Trustworthy

Data Management

Technical Troubleshooting

Windows XP/Vista

Hardware Diagnostics

Call Center Operations

Hardware Upgrades

Hardware and Software Repair

Teamwork and Collaboration

Microsoft Windows and Office

Troubleshooting Network Issues

Tracking and Documentation

Help Desk Support

Report Generation

Creative Problem Solving

Multitasking and Prioritization

Upselling Products and Services

Customer Retention Strategies

De-escalation Techniques

B2B and B2C Sales

Sales Closing

Conflict Mediation

Data Evaluation

Creative Problem Solving

Issue and Complaint Resolution

Customer Service

De-escalation Techniques

Customer Retention Strategies

Responding to Difficult Customers

Inbound and Outbound Calling

Sales Expertise

Technologically Savvy

Store Maintenance

Quality Control

Clerical Support

Route Management

High-Energy Attitude

Upbeat and Positive Personality

Calm and Professional Under Pressure

Building Customer Trust and Loyalty

Understanding Customer Needs

S K I L L S

717-***-****

Baltimore MD, 21215

adzu0f@r.postjobfree.com

Knowledgeable Customer Service and Credentialing Specialist brings many skills such as performing successful application checks and verifying informational resources. More than 10 years of experience overseeing data access and security based on up-to-date trends and standards. Quickly adept at verifying primary sources and access-level tiers. Proven communicator and relationship builder expertly tracks complex update, certification and credential requests.

P R O F I L E

E X P E R I E N C E

Helping Hands Health Services Remote

First Choice Medical Counsulting

2020-Present

2013-2020

CREDENTIALING SPECIALIST

Assisting with check posting and balancing for third party insurance carriers. Resolve failed claims and denials.

Handle insurance appeals and daily electronic report generation of claims sent to the clearing house .

Update patient demographics and insurances. Resolve calls with insurance companies and patients

.Input data of medical billing, posting credit card and copayments. Managed all payments processing, invoicing and collections tasks. Collected, posted and managed patient account payments. Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.

Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.

Performed insurance verification, pre-certification and pre-authorization. CREDENTIALING COORDINATOR

Resolve technical issues related Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access. Performed database queries, compiling information according to requests and logging logistics changes.

Completed enrollments into Medicaid, Medicare and private insurance plans. Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.

Checked applications for missing information and organized all paperwork. Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.

Performed primary source verifications such as criminal histories, licenses and board certifications. QMB Medical Staffing Agency 2008-2013

MEDICIAD BILLING SPECIALIST

Kept close tabs on documentation expiration dates, communicating with correct personnel to submit files prior to expiration.

Offered high level of assistance during managed care auditing process and conducted internal file audits.

Checked applications for missing information and organized all paperwork. Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.

Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.

Verified documentation against compliance standards and communicated deficiencies to resolve issues.Collected and reviewed data to identify potential compliance issues requiring further review.

Evaluated applications and associated documentation to determine eligibility. E D U C A T I O N

Walbrook High School

1993

DIPLOMA

C E R T I F I C A T I O N

Customer Service Certified

Microsoft Office

Keyboarding & Typing 101

Penn Foster College

CURRENTLY ENROLLED



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