Customer Service Representative
Resume:
Jessica Gibbons
Hodgenville, KY *****
***************@*****.***
Professional Summary
Currently attending college to complete associates in Medical information technology- medical coding track
Authorized to work in the US for any employer
Work Experience
Medical Data Entry Specialist
Capgemini-Remote
August 2024 to Present
Make outbound phone calls to our members and prescribers
• Utilizing multiple software systems to complete Medicare Enrollment case reviews
• Meeting or exceeding government mandated timelines
• Complying with turnaround time, productivity and quality standards
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
• Process pre-edits for SilverScript applications
Billing Customer Service Representative
AmSurg-Remote
February 2024 to August 2024
responsible for handling a variety of customer service calls in a prompt and courteous manner. Resolves patient questions and problems regarding patient accounts, payments, and services. Answering on average 65 calls a day. Worked with Prior authorization and claims. Create an atmosphere of comfort, peace and make it easy for the patient; the patient is our first business. Customer Service Representative
ResultsCX-Remote
October 2023 to February 2024
I assisted ResultsCX customers with a wide range of healthcare related inquiries! Calls were included, but are not limited to, detailed reviews and change requests on member insurance plans, healthcare screening or appointment scheduling, assisting members with finding a primary care physician in their network, and more. I handled both inbound calls and outbound campaigns to inform the customers about changes that may affect them. Worked with Prior authorization and claims Regular contractor/Medicaid Verification Agent
BCforward/Accenture-Remote
August 2023 to October 2023
• As a Medicaid Verification Agent I conduct searches on returned Medicaid enrollment letters. Complete searches in various systems for the client addresses in the State’s Medicaid system.
• Perform Online Searches for new address information for Medicaid clients
• Address Verification
• Accurately enter information into database
• Perform special research
• Other duties as assigned like renewing benefits or starting new benefits.
• Worked with Prior authorization and claims
Customer Service Representative/Project based
SupportNinja-Remote
December 2022 to April 2023
Main Duties and Responsibilities:
To interact with the customers/clients in order to answer questions, resolve support issues, improve credibility, and nurture relationships.
Job Responsibilities • Must have good communication skills
• Maintains a positive, empathetic and professional attitude toward customers at all times
• Worked with Prior authorization and claims
• Responds promptly to customer inquiries
• Communicates with customers through various channels; chat, email & phone
• Acknowledges and resolves customer complaints
• Obtains product mastery in order to respond to the customers’ concerns promptly and accordingly
• Processes orders, forms, applications, and requests
• Keeps records of customer interactions, transactions, comments and complaints
• Communicates and coordinates with colleagues as necessary
• Provides feedback on the efficiency of the customer service process
• Provides comprehensive and professional customer support to ensure customer satisfaction Client Service Specialist 1-Health Concierge
Computech Corporation/B-swift-Remote
September 2021 to November 2022
Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing. Ability to work in a fast paced environment, handling both inbound and outbound calls. Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines. Good communication skills are essential, both internal and external. Knowledge of Medicare benefits, enrollments and LIS assistance. Plans and organizes work assignments, set priorities and completes work with a minimum of supervision. Adheres to the service policy and principles of the company, as well as the program guidelines set by the department. Participates in cross-training to perform all roles within the department. Communicates effectively and professionally with our program partners to assure the best possible service for our patients and partners.
Billing Specialist
Sedgwick-Remote
April 2021 to September 2021
• Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Worked with Prior authorization and claims
• Educates and informs the customer via multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status.
• Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner.
• Enters verbal and written application information that meets both the internal and external customer’s requirements accurately into the claims management system.
• Assigns new claims to the appropriate claims handler.
• Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center Specialist/management as needed.
Education
Undergraduate in Medical Technology
Elizabethtown Community and Technical College - Elizabethtown, KY January 2022 to Present
Associates in Culinary Arts in Culinary Arts
Sullivan University - Louisville, KY
August 2004 to August 2006
Skills
• Excel
• Customer Service Skills
• Scheduling
• Data collection
• Organizational Skills
• SharePoint
• Restaurant experience
• Retail sales (Less than 1 year)
• Computer networking
• Google Suite
• problem solving
• Retail (Less than 1 year)
• Zendesk
• Windows
• Powerpoint
• Restaurant experience
• Food service (Less than 1 year)
• Zendesk
• Ms office (Less than 1 year)
• Administrative Skills (10+ years)
• ICD-10
• fast learner
• Microsoft Access
• Typing (6 years)
• cooking (Less than 1 year)
• Medical Billing (4 years)
• Multi-line phone systems
• Customer support
• Research
• Marketing
• Data collection
• cold calling (Less than 1 year)
• HIPAA (4 years)
• Sales, retail & customer service support (5 years)
• EMR systems
• Medical coding (4 years)
• Research
• Filing
• ICD-9
• CRM software
• Google Docs
• Medical terminology
• Operating systems
• Communication skills
• Anatomy knowledge
• Information management
• Phone Etiquette (10+ years)
• Medical Office Experience
• Data entry (Less than 1 year)
• PCI
• Basecamp
• Account Management
• Typing
• Salesforce
• Insurance verification
• Administrative Assistant (4 years)
• Sales
• Microsoft
• Computer literacy
• Technical Support
• Microsoft office (Less than 1 year)
• Document management systems
• Retail marketing (Less than 1 year)
• EHR systems
• Intake
• Microsoft Excel
• Physiology knowledge
• Receptionist (Less than 1 year)
• Telemarketing (Less than 1 year)
• NetSuite
• Time Management
• Salesforce
• Documentation review
• Documentation review
• Microsoft Outlook (4 years)
• Customer service
• Hospitality
• Hospitality
• Billing
• Search engines
• Culinary Experience
• Management
• Software troubleshooting
• prospecting (Less than 1 year)
• Medical terminology
• Business Development
• Telemarketing
• Live chat
• Microsoft Access
• English
• Medical records (4 years)
• telesales (Less than 1 year)
• b2b (Less than 1 year)
• Windows
• Continuous improvement
• Food Preparation
• Customer service (Less than 1 year)
• Databases
• Compliance management
• NetSuite
• Administrative Assistant (3 years)
• Medical information (2 years)
• Software troubleshooting
• Clerical experience
• Kitchen (Less than 1 year)
• Paylocity
• Analysis skills
• Microsoft Word (9 years)
• Inside Sales
Certifications and Licenses
Medical receptionist
May 2023 to Present
Data entry operator
May 2023 to Present
I have photo of certificate from Elizabethtown Community and technical college
Contact this candidate