Customer Service Representative

Juanita Royster

Milwaukee, WI *****

Signify Health Nov 2023-Present

Member Engagement Coordinator

Make an average of 50 outbound calls per hour placed by an automatic dialer system to offer, explain, and schedule a free in-home or virtual health evaluation with a provider.

Follow 20+ approved scripts, ensure members understand and are comfortable with the terms, and respond to rebuttals persuasively and with professional courtesy.

Bringing a positive, professional, and high-energy approach, effectively managing relationships with leading health insurance companies like BCBS, UnitedHealth and others, ensuring seamless communication and outstanding service for clients and health plan members.

Meet daily goals set by the department (i.e., 300-400 outbound dials per day, 24 appointments set per day, shift and attendance policy adherence, quality targets, etc.) in an office or remote environment.

Adjust, reschedule, and cancel appointments with both members and contracted providers, as requested.

Monitor performance results including appointments, calls, handle time, and productivity using designated reporting systems.

Report on member complaints and escalations immediately to Member Engagement Managers.

Participate in peer side-by-side coaching as needed.

Follow HIPAA and other security and privacy guidelines when managing protected health information accessed during normal work activities.

Experience in managed care contracts including DRG, per-diem, per visit, and fee schedule.

Identifies denial trends and reports issues to Insurance Follow-up Coordinator/Insurance.

Follow-up Supervisor for escalation with payer liaisons.

Using knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Manual), HMO/PPO agreements and other contractual arrangements.

Morley Corporate Apr 2021 -Oct 2023

Customer Service Representative/ Order Entry Specialist/Customer Support Representative

Answer incoming calls from customer's regarding recalls and on vehicles.

Communicate with customers about their warranty information if it was still active or not.

Coordinate with dealers on behalf of customers to check parts availability.

Schedule service appointment as well.

Well versed Used ERP tools which includes SAP, Oracle and sales workbench for daily entry of record and information.

Sitel Sep 2020 – Apr 2021

Customer Service Representative

Responsible to answer incoming calls from members.

Handle disputes and search order history for the members.

Responsible to Issue exchange orders as well.

Carvana - Oak Creek, WI May 2019 – Dec 2019

Order Entry Specialist/Customer Support Representative

Created customer’s files with the paperwork they need to fill out and also printed their checks.

Made outbound calls to customers to remind them of their appointment and when we were on our way.

Performed order entry, processing and placing customer orders.

Provided excellent customer service.

Drove the customer’s cars back to the office.

Walter USA Dec 2018 – Mar 2019

Order Entry Specialist/Customer Service Representative

Entering work orders in SAP and Siebel system.

Answering the phone calls of customers to check the status of their orders, Place orders over the phone.

Answered the Emails.

Provided 100 Customer satisfaction.

Harley Davidson - Milwaukee, WI Apr 2018 – Oct 2018

Order Entry Operator/Customer Service Representative

Worked in the ecommerce department handling inbound customer service-related questions over the phone, via email, as well as via the chat system.

Placed customer orders and processed payment for the orders using Siebel system.

Researched customer orders through the UPS website.

Processed refunds to customers.

JC Penny’s through Randstad - Greendale, WI Oct 2017 – Mar 2018

Customer Service Representative II

Handled average of 60+ calls in a day dealing with the customers on their concerns and queries.

Handled escalation calls, follow up with the customer on their orders and taking care of the customer’s payment.

Smart Choice MRI - Mequon, WI Jul 2016 – Aug 2017

Patient Scheduling and Insurance Specialist

Schedule patients for their MRI an appointment.

Answer phones and handles calls in a professional and timely matter.

Maintains communication interactions at all times w/patients, referring doctor’s office and Insurance companies.

Schedule patient’s appointments according to their orders.

Ensure all patients personal, financial and insurance information is entered in correctly.

Enter patient’s orders via answer phones, chat, and email.

Make outgoing calls to insurance companies for precertification or any authorization.

Obtain prior, OP reports and lab results based on patient’s age and order.

Actively listen to patients’ needs in the telephone and show empathy to every patient.

Receives preauthorization from patients and/or insurance companies.

Verify patient insurance benefits.

Experience in managed care contracts including DRG, per-diem, per visit, and fee schedule.

Identifies denial trends and reports issues to Insurance Follow-up Coordinator/Insurance.

Follow-up Supervisor for escalation with payer liaisons.

Using knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Manual), HMO/PPO agreements and other contractual arrangements.

Manpower Corporation - Milwaukee, WI Oct 2015 – Jun 2016

Customer Service Representative

Handled inbound calls from customers and enter the information in customer data about billing and payroll issues.

Enter work orders.

Customer service, very detailed orientated.

Billing and processing of payments and also upgraded customers to other services per request.

Time Warner Cable - Milwaukee, WI Mar 2015 – Sep 2015

Customer Solution Representative

Handled inbound and out bound and resolution customer issues in one call.

Daily entry of information and records.

To meet customer need and fulfill their requirements.

Reviewing and entering customers’ orders.

Billing and processing of payments and also upgraded customers to other services per request.

Used tools like Oracle and sales workbench for daily entry of record and information.

Responsible to adhere the customer about policies and processes to ensure compliance.

U.S. Cellular - Waukesha, WI Oct 2013 – Dec 2014

Customer Service Representative

Use effective decision making to achieve our goal of resolving our customer issues in one call.

Retrieving and documenting customer information while listening intently to your customers demonstrates your ability to effectively manage multiple tasks.

Responsible for compliant execution of customer issues on daily record basis without any delay.

Inbound is to receive all incoming calls for cell phone accounts.

Processed ESN swaps of phones, suspend phone service, transfer and disconnect service as well.

Cross selling, dealing with high bill complaints also did trouble shooting of phones when not working properly.

Customer service, Very detail oriented, Process payments.

Used tools like Oracle, and sales workbench for daily entry of record and updating the data of the company.

WE Energies - Waukesha, WI Dec 2010 – Sep 2013

Customer Service Consultant

Inbound is to receive all incoming gas, electric, and steam contacts from customers.

Respond to questions/ inquiries/requests including bill inquires, payments arrangements.

Set up start service orders, disconnects, and reconnects, transfers, trouble calls, gas emergency calls,and new construction orders.

Entered detailed customer information into the Siebel/CRM system.

Cross selling, dealing with high bill complaints and redirect the customers to appropriate company personnel if necessary.

Cancel and re-billed accounts based on meter reading accuracy.

Negotiate and determine budget amount by analyzing customer usage.

Adjust estimated factor and re-bill if necessary.

Customer service, very detailed orientated.

Set up appointments to have gas or electric meters’ exchange.

Handle outage calls and enter orders for emergency.

Used SAP to enter the orders.

Went over customers’ bills so that they understood.

Time Warner Cable - Milwaukee, WI Jun 2006 – Dec 2010

Customer Service Representative/ Order Entry Representative

Processed order from our Direct Sales Rep. for Cable, Internet, and telephone.

Processed orders from our Telemarketing dept. for cable, internet, and phone.

Processed payments for new service or current customers.

Entered detailed customer information into the Siebel/CRM system.

Identified and resolved issues in order to process through vigilant motoring of various queues and order states.

Analyzed and performed root cause analysis of the daily invalid and rejected orders to address and resolve issues.

Also trained all new hires that came into the department.

Created new hires packets.

Review and entering of orders.

Responsible for maintenance of backlog quality.

Trained hire to enter orders and what codes the department used.

Billing and processing of payments and also upgraded customers to other services per request.

Met sales goals for upgrades, installations, and add on sales while in Customer Service.

Completion of all tasks and projects within stated time frames.

EFunds Corp - Milwaukee, WI Jan 2003 – Jun 2006

Accounts Receivable Clerk

Processed telecoms invoices from different vendors.

Opened daily mail and scanned to India for processing and then I would go in and batch them up and make payments and send them out.

Managed my own accounts, Vanguard, MCI, AT&T process them and enter into the system and processor payments.

Required research circuits and make sure they were still active or disconnect circuits and put in new ones per request of vendors.

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