Customer Service Representative

Mercedus Peace

Cell:984-***-**** ***********@*****.***

Profile

Detailed remote customer service representative service rep with over 1 years of providing support to customers via phone and email. Expertise in delighting customers with timely, accurate, and personable service. Key achievement: responded to over 2K emails and phone calls within 48 hours regarding billing, account information, and general inquiries from customers.

Experience

McDonald’s Crew Member NOVEMBER2021- Currently

● Providing friendly and efficient service to customers, handling complaints, and ensuring customer satisfaction.

● Collaborating with team members to ensure smooth operations, especially during busy periods.

● Efficiently managing time to complete tasks quickly and accurately, especially during peak hours.

● Addressing and resolving issues that arise during shifts, whether with equipment, customers, or team dynamics.

● Effectively communicating with team members and customers to ensure orders are accurate and service is efficient.

● Adjusting to different roles and responsibilities as needed, depending on the shift and team requirements.

Hibbett Crew Member August 2024- Current

● Delivering friendly and effective service to help customers find the right products and improve their shopping experience.

● Demonstrating product features and benefits to drive sales and achieve store goals.

● Assisting with stock management, including receiving shipments, organizing merchandise, and conducting inventory counts.

● Creating attractive product displays and arranging merchandise to engage customers and promote sales.

● Working effectively with coworkers to promote a positive team environment and meet store objectives.

● Balancing multiple tasks effectively, especially during peak shopping times and sales events.

● Adjusting to the fast-paced retail environment and changes in customer demand or product availability.

CUSTOMER SERVICE REPRESENTATIVE HUMANA February 2023 -February 2024

• Answered calls from physician offices, hospitals and patients using exemplary customer service skills.

• Finalized claims and generated Explanation of Benefits and Explanation of Payment

• Assessed and dispersed members call for Mental Health and Substance Abuse services.

• Attended appeal hearings for representation of company, and appealed denials based on medical necessity.

• Appointed liaison between care providers and customers to aid with appointment scheduling, or connection to internal specialists to obtain appropriate medical services.

• Familiarized with HCPS codes, place of service codes, revenue codes and diagnosis codes for job-related responsibilities.

Education

Jf Webb High School Diploma June 2024

Skills & Abilities

· Appeals Patient Financial Services

Insurance/

· Poised under pressure

· Benefit Verification Compliance &

Regulatory

· Knowledge Prior Authorizations/

Preservice

· Review Research and Analysis Patient

Accounts Collections

· Athena

· Epic

· Pulling Parts

· Production

· Order Picking and Processing

· Daily Logs

· Experienced in most restaurant

positions

· Fun and energetic

Activities and Interests

Theater, environmental conservation, art, hiking, skiing, travel Responsible for following-up on outstanding claims list month Following up on A/R monthly to keep accounts current

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