Customer Service Call Center
Resume:
Shayla Cojocaru
Customer service representative
Sacramento, CA 95838
************@*****.***
Authorized to work in the US for any employer
Work Experience
Provider Services Representative
Centene-Sacramento, CA
June 2023 to May 2024
I performed daily duties of ensuring that providers (individual, group, ancillary, etc.) were set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting, directories, and claims payment resolution related to provider setup.
• Provide support to the external provider representative to resolve provider data issues
• Research and effectively respond to provider-related issues
• Submit provider data entries to resolve provider-related demographic information changes
• Initiate and process provider add, change, and termination forms
• Create and maintain spreadsheets used to produce provider directories for multiple products.
• Track, update, and audit provider data
• Identify adds, deletes, and updates to key provider groups and model contracts
• Research and identify any processing inaccuracies in claim payments and route them to the appropriate site operations team for claim adjustment
• Assist providers with website registration
• Facilitate provider education via webinar
• Work with other departments on cross-functional tasks and projects
• Facilitate new provider orientations
• Facilitate provider training
• Completes special projects as assigned
Customer Care Representative
Amerit-Sacramento, CA
April 2022 to August 2022
My duties include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards. • Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
• Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
• Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction. Customer Service Representative
Maximus-Folsom, CA
March 2021 to July 2021
Assisting callers in finishing online applications - Completing daily electronic call logs - Filling out timesheets - Adhering to privacy rules - Connecting callers with leadership as needed - Maintaining up-to-date knowledge of regulations and policies as they apply to the healthcare programs we service
- Reporting problems through an easy online system - Responding to telephone inquiries within set time parameters. Provide product/services information, answer questions, and resolve any emerging problems that the customer accounts might face with accuracy and efficiency.
• Assisted customers with a warm and professional attitude
• Answered general questions
• Resolved customer information and complaints
• Provided policy and service information
• Set up client appointments
• 40 to 50 calls a day in the call center.
• Worked in the inbound call center
Disaster Recovery Specialist
U.S. Small Business Administration-Buffalo, NY
August 2020 to February 2021
• Responds to complex customer inquiries, providing general information to the public regarding federally declared disasters and SBA's disaster loan program. Assembles and issues home and business loan applications packets to disaster survivors. Answers routine questions regarding loan closing and disbursement process,
• Responded to 30 to 50 calls per day.
• Inbound call center
Customer Service Representative
Fanuiel-Sacramento, CA
August 2017 to August 2019
I answered questions and resolved problems. When a customer calls and has an issue that needs to be handled, I deliver excellent customer care and create sustainable value for customers. I investigate, process, resolve, and respond to the member, provider or beneficiary inquiries received via multiple contact methods regarding benefits, eligibility, materials forms, ID cards, PCP changes, complex inquiries and quality care issues.
• Respond to 80 to 100 calls per day
• Worked in the inbound call center
Cashier
Travis AFB Commissary-Fairfield, CA
August 2013 to December 2013
Operate an electronic checkout system, makes change and verifies change fund and amount of currency received during an assigned shift.
Manage change machines ensuring proper amounts of cash and coins are available. Assist customers by answering questions concerning prices, identification and location of items. Count cash and negotiable instruments and prepares an accountability report. Manage the self-check-out registers assisting customers in the correct processing of their purchases. Changed register tape and clears routine equipment and scanning jams on registers. Answered and quickly redirected up to 10 calls per hour. Greeted numerous visitors, including VIPs, vendors and interview candidates. Office Assistant
Correctional Medical Facility-Vacaville, CA
July 2010 to July 2012
California Medical Facility 80 Hour BI-Weekly Under the direction of the Principal or the Vice Principal, Academic
Education Programs, the Office Assistant (Typing) provides clerical support to multiple professional staff within the Education Department (Education).
The Office Assistant (OA) will work in a school environment supporting the entire educational staff, including the Principals, Vice-Principals, and teachers. The incumbent will maintain filing systems and tracking spreadsheets for assessment, Test of Adult Academic Education
(TABE) scores.
Comprehensive Adult School Assessment System (CASAS) assessments, correspondence, and other documents created by and received into education.
The OA will perform routine tracking, filing, and maintenance of various education reports and assessment data.
Achievements Kept the Correction Education Testing department under budget thereby allowing more students to be tested.
Ordered office and testing supplies for the testing department. Ordered and distributed office supplies while adhering to a fixed office budget. Managed office supplies, vendors, organization and upkeep. Directed guests and routed deliveries and courier services. Education
AA in Psychology
Solano community college
2004
High school diploma or GED
Skills
• 10 key typing
• Flexible windows 8 and 10, Excel.
• Outlook
• Cash Handling
• Research
• Customer Service
• Computer literacy
• Medical terminology (2 years)
• English
• Microsoft Word
• Writing skills
• Clerical Experience
• Skills.Telephone Answering, 12-Line system.
• Power point
• Computer Operation
• Analysis skills
• CRM software
• Microsoft Excel
• 10-Key Calculator
• Conflict management
• Word processing
• Manufacturing
• Social media knowledg
• SAP
• Customer service-oriented
• Pleasant demeanor
• Professional phone etiquette
• Articulate and well-spoken
• Hospitality
• SQL
• Windows
• Customer support
• Network Support
• Disaster Recovery
• Microsoft Powerpoint
• Microsoft Windows Server
• Communication skills
• Front desk
• Word Processing and Typing 45 wpm .
• Excellent communication skills
• Time management
• Benefits administration
• Microsoft Outlook
• Office Administration
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