Customer Service Representative
Resume:
Sakeenah Griffin
Columbia, SC *****
*********@*****.***
Authorized to work in the US for any employer
Work Experience
Eligibility Specialist
TEKsystems-Columbia, SC
July 2024 to Present
Meeting to the needs is South Carolina residents for Healthcare benefits.
• Updating demographics
• Deemed babies
• ABD/SOCIAL SECURITY Applicants.
• Ensure Accuracy from individual application and declaration forms are complete.
• Resolve discrepancies: Secure documentation, medical records, and provide excellent customer service.
Medical office technician / Certified Medical Assistance Lexington Medical Center Endocrinology-West Columbia, SC April 2023 to Present
• Rooming 15-20 patients a day.
• Injections
• Create and generate electronic forms requesting patient documents from physicians.
• Collect and manage patient eligibility documents such as prescriptions, certificates of medical necessity, letters of medical necessity and prior authorizations.
• Contact doctor offices as necessary to collect prescriptions, certificates of medical necessity, letters of medical necessity, clinical notes, and lab results.
• Contact insurance companies to collect approved prior authorization.
• Palmetto Infusion Referral and Adapt Health paperwork.
• Ozempic, Monojouro,and other Endocrinology Rx.
• Understand and following Medicare, Medicaid, HIPAA and Private insurance regulation and requirements.
Customer Service Representative
Florida Pest Control-Florida
January 2023 to July 2023
• Meeting the needs of clients.
• Scheduling appointments such as, pest, lawn, termite and much more.
• Inbound calls 40-60 a day.
• Outbound, email to techs, Om, and District Managers.
• Processing payment on accounts.
Benefits Specialist- Remote
AmerisourceBergen with Lash Group-Fort Mill, SC
May 2022 to March 2023
Process enrollments, additions, changes, terminations, for group medical, ancillary and worksite products.
Respond to agents, groups, carriers and internal staff within required timeframes and record in internal database system.
Enter all pertinent information obtained from employee change forms from groups into internal database system.
Assist as needed with ID card requests, invoice requests.
• Excel and workbooks
• 20-40 records a day
• Npt tool
• Med connect
CSR - Customer Service Representative- Remote
Molina Healthcare-California
January 2022 to December 2022
Made warm outbound calls to encourage health plan members to schedule healthcare-related in-home and virtual assessments
Supporting our Healthcare Provider client by educating, informing, and encouraging plan members and their families to participate in health programs to improve overall quality of life. Outbound calls 100 or more a day.
Send emails.
Verify and authenticate account information.
Work Excel.
HUB.
MICROSOFT TEAMS.
Remote.
Medical Claims Specialist Remote
Conduent Business Services, LLC (Formerly Xerox)-Columbia, SC April 2019 to December 2021
• South Carolina Department of Health & Human Services.
• Provide outstanding customer service to patients over the phone while managing a high volume of inbound and outbound calls
• Schedule patient appointments, obtain insurance authorizations, and answer questions to ensure patients’ needs are met
• Serve as liaison for client, account representatives and managers, while effectively interfacing with internal and external team members and hospital staff
• Identify additional opportunities to add value with patient needs
• Complete insurance verification processes and obtain insurance authorizations, referrals, and treatment consultations
• Obtain diagnosis information and/or CPT code as necessary to complete the insurance authorization process.
• 50 or more calls per day)
• Work from home the last 16 months.
• Microsoft Team
• Word excel
• Call center manager for 1 year.
• Medicaid Magi Reviews (pregnancy,long-term care, and social security clients). Strong oral communication skills.
Day to Day skills with Onbase, Meds, Curum and MMIS systems. Strong Keyboard skills
Customer Service Representative
Entergy Texas-Texas
December 2020 to June 2021
• Inbound calls 50-60 a day
• Assist customers with payments, payment arrangement, extensions.
• Create new account on our online portal.
• Add new clients to our services
Shift Leader
Bojangles' Restaurants, Inc-Columbia, SC
July 2018 to October 2019
• Work in fast paced environment
• Created employee schedules
• Handled monetary transactions including deposits
• Open and closed stores
General information system CSR
City of Columbia, SC-Columbia, SC
March 2017 to January 2018
Verify employment information.
Verify address.
Inbound/Outbound calls 40-100 a day.
Working very fast paced.
Customer Service Representative
Teleperformance-Columbia, SC
March 2016 to July 2017
• Processed payment for IRS customers
• Full verification on all callers.
• The opportunity to service customers or prospective customers via inbound telephone calls.
• Provide first call resolution for all retail banking inquiries,commercial inquiries Bankcard, fraud, forgery, ID theft, and policy and procedure questions.
• In addition to service support of the identifying potential cross-sell opportunities and referring to the appropriate sales area within the bank.
• Provide specialty area of support in one of the following categories, bank fraud and so much more. Shift Lead
Travel Centers of America-Manning, SC
July 2008 to March 2014
• Provided excellent customer service
• Seated customers and made sure dining needs were met.
• Employee of the month twice. For best customer services.
• Coordinate inventory and product placement.
• Follow up with customer inquiries to provide great customer service Sanitation Worker
Pilgrams Pride-Sumter, SC
April 2006 to April 2008
• Maintained the regulations of USDA.
• Handled heavy equipment for sanitation.
• Certificate for Lead Sanitation Trainee Worker.
• Followed all Quality Assurance Guidelines
Education
Diploma in Medical Assistant
Remington College - Columbia, SC
October 2015
High school diploma
Manning High School
August 2001 to May 2004
Skills
• Medical Records
• Anatomy Knowledge
• Quality assurance
• Call center management
• CPT
• Insurance Verification
• Medical Billing
• Medical Coding
• ICD Coding (1 year)
• Vital Signs
• Medical Terminology Records (2 years)
• Microsoft Powerpoint
• Patient Care (2 years)
• Experience Administering Injections
• Ub-04 and CMS- 1500 claim forms
• Phone Etiquette
• Time management
• Electronic Health Records (Less than 1 year)
• ICD-10
• Data Entry (2 years)
• Sales
• ICD-9
• QuickBooks
• Microsoft Office: Word, & Excel
• HCPCS CODES
• EMR Systems
• Medical Office Experience (2 years)
• Customer service (10+ years)
• Medical Scheduling
• HIPAA
• Microsoft Excel
• Transcription
Certifications and Licenses
Certified Clinical Medical Assistant (CCMA)
September 2016 to September 2024
AED Certification
PALS Certification
Compact State Nurse License
CCMA Certification
Certified Ophthalmic Assistant
Certified School Nurse
ACLS Certification
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