Service Representative Customer

Master of Science (MS), Social Work; Kent School of Social Work, University of Louisville

Bachelor of Arts (BA), Psychology; University of Louisville

TECHNICAL SKILLS

Microsoft Office Programs: Excel, Word, PowerPoint, SharePoint

Humana systems: Metavance, CI, Oracle

Centers for Medicare & Medicaid Services (CMS) systems

Activities and Leadership

EXPERIENCE

KnippeRx

January 2023 – May 2024; Customer Service Representative

Answered inbound and outbound phone lines for pharmacy and provided first call resolution whenever possible while meeting or exceeding service level goals

Investigated issues that could not be resolved on the initial call and followed each issue through to issue resolution

Accurately captured information and updated systems appropriately

Floor and Decor

November 2021 – March 2023; Sales Associate

●Coordinated sales and installation of flooring for residential and commercial customers

●Greeted customers and responded to questions and requests

●Organized racks and shelves to maintain store visual appeal, engaged customers, and promoted specific merchandise

Humana Inc.

January 2003 – April 2016

Employment Verification 1-888-***-****

October 2014 – April 2016; Frontline Leader, Service Fund

Identified reasons for variation in individual performance and took appropriate actions resulting in performance improvement

Coordinated meetings with Service Fund, Finance, and markets to ensure contracts were loaded correctly

Led the first summit between the Louisville Service Fund Teams in San Antonio with the market offices. This was a successful meeting resulting in increased communication, productivity and accuracy.

October 2013 – October 2014; Team Lead, Special Investigations Unit (SIU)

Led market meetings with providers, clinical review, and management when a provider consistently billed incorrectly

Addressed learning opportunities when associates were struggling with concepts

Performed case reviews with team members to determine status and next steps

May 2011 – October 2013; Special Investigator, Special Investigations Unit

Identified and investigated potential health insurance fraud by reviewing medical records, claims, phone interviews, and referrals with clinical review team

Reported suspected fraud, waste, and abuse to the Department of Insurance, CMS, other insurance carriers, and law enforcement

EDUCATION

President of Savannah Row Condo Assoc., 2007, 2016

Vice President of Savannah Row Condo Assoc., 2008

School Basketball Coach, 1992-2003

Asst. Scout Master 1990-2001

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