Customer Service Experience

Nakia Cole

***********@*****.*** 972-***-****

Dallas, TX

SUMMARY

Motivated and reliable Certified Phlebotomy Technician seeking an entry level position within a reputable company that will allow me to grow within my career and gain experience in a patient care role. I have 12 years' experience in healthcare and customer service environments. Proficient in medical terminology, patient advocacy, and delivering exceptional customer experience by resolving inquiries and coordinating care. I am skilled in managing confidential information, health insurance claims, and maintaining detailed documentation to support informed decision-making and enhance patient satisfaction.

WORK EXPERIENCE

Employer Direct Health Care

Customer Experience Specialist Feb 2024 - Present

• Engaged and educated new and existing members about the Surgery Care offering, ensuring clarity and understanding of benefits.

• Advocated for members by coordinating appointments and travel, assisting in selecting appropriate venues.

• Delivered accurate information and support through phone, email, and chat in a professional manner.

• Collaborated with healthcare providers, insurance companies, and third-party partners to ensure coordinated and comprehensive care for members.

• Assisted members in understanding their medical provider options to facilitate informed decision-making.

• Addressed member concerns via chat, email and phone related to medical care and scheduling to enhance satisfaction.

• Assisted with provider selection to meet individual member needs effectively.

• Maintained accurate data entry/documentation of member interactions, detailing concerns, actions taken, and outcomes with two minute SLA after disconnect of initial method of communication.

• Followed up, resolved, and documented issues, directing inquiries needing further investigation to the appropriate department.

• Managed highly sensitive information, ensuring compliance with Personal Protected Information (PPI) requirements.

• Consistently achieved an average handle time of less than 9 minutes per call, maintained a monthly quality rating of 91% or greater, and achieved case audit success with an error ratio of less than 4%. Cornerstone Staffing

Patient Advocate Sep 2019 - Jan 2024

• Respond to and resolve patient and healthcare provider inquiries via email, chat, and phone, ensuring timely and effective communication.

• Manage electronic patient documents and information securely and efficiently, maintaining organizational standards.

• Provide support for health insurance claims by reviewing, researching, and processing to facilitate accurate claim adjustments.

Willis Towers Watson

Customer Service Rep Mar 2017 - Sep 2019

• Delivered exceptional customer service by addressing inquiries and resolving issues related to defined benefit pension and health and welfare plans.

• Managed confidential information with sensitivity, adhering to HIPAA, Data Privacy laws, and company data security protocols.

• Simplified complex health, welfare, and pension information into clear, actionable guidance for customers. CGS Administrators

Customer Service Advocate Apr 2015 - Mar 2017

• Responded to and resolved customer inquiries and issues on the first call, identifying assistance needs related to payments, eligibility, registration, and attestation.

• Intervened with healthcare providers on behalf of customers to assist with claims, ensuring real-time resolution or timely follow-up.

• Provided technical support for customers navigating healthcare websites for enrollment and claims, researching complex issues across multiple databases and coordinating with support resources for escalated issues. State Farm Insurance

Customer Service Rep Jan 2013 – Apr 2015

• Completed electronic processing of customer contract forms and service orders, and maintained quality control records to enhance customer service.

• Assisted customers through various channels to provide information on products and services, manage account changes, and communicate claim investigation outcomes. EDUCATION

Lincoln High School

General Course Diploma, General Studies

CERTIFICATIONS

Dallas

, Tx

2008

Certified Phlebotomy Technician, National Healthcare Association 2025 SKILLS

Customer Experience • Medical Terminology • Health Insurance Claims • Terms of Service • Technical Support • MS Office/G-Suite • Critical Thinking • Risk and Compliance • Issue and Complaint Resolution • Multi-Tasking and Prioritization Skills • Specimen Handling • Empathy • Patient Interaction • Venipuncture Proficiency

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