Customer Service Representative

COLLINGDALE, US, ***** • **********@*****.*** • 267-***-****

KARON JACKSON

Professional Specialist

PROFESSIONAL SUMMARY

Professional Specialist with over 13 years of extensive expertise in healthcare and administrative support, specializing in patient care and financial analysis. Demonstrates strong proficiency in data entry, problem-solving, and medical billing, ensuring compliance with HIPAA standards. Committed to enhancing service quality and operational efficiency through effective communication and quality assurance.

EMPLOYMENT HISTORY

CLIENT SERVICES REPRESENTATIVE Feb 2025 - Present

Pond Lehocky Giordano LLC Philadelphia, PA

TIER 1 CUSTOMER SERVICE REPRESENTATIVE (TEMP CONTRACT) Nov 2024 - Jan 2025 Optum Philadelphia, PA

MEDICARE CUSTOMER SERVICE REPRESENTATIVE Jun 2024 - Nov 2024 Independence Blue Cross Philadelphia, PA

Process daily fees, ensuring database accuracy for SSD cases. Confirm award letter details, communicate with clients. Generate end-of-day reports for leadership review. Manage new decisions in the Case Management system. Analyze award letters, validate compliance to protect client interests. Coordinated with clients and team members to verify award letter details, facilitating clear communication and timely case progression

Generated comprehensive end-of-day reports for leadership review, enabling informed decision-making and workflow optimization

Streamlined case management system updates for new decisions, improving processing efficiency and maintaining data integrity

Handled inbound calls, boosting patient satisfaction and service quality. Resolved patient queries, ensuring clear communication and understanding. Scheduled appointments accurately, optimizing clinic operations. Coordinated referrals, maintaining seamless patient care. Managed high-volume inquiries, resolving insurance concerns effectively. Orchestrated effective communication between patients, physicians, and medical offices, facilitating smooth information exchange and enhanced care coordination

Maintained consistent compliance with departmental standards while processing multiple work queues, contributing to improved operational efficiency

Addressed customer needs, ensuring effective solutions and satisfaction. Documented interactions for timely follow-up and trend analysis. Resolved complaints swiftly, adhering to policies and regulations. Maintained professionalism and empathy in all member interactions. Enabled data-driven insights for Medicare service improvements. Fostered strong relationships with internal departments and healthcare providers, facilitating seamless coordination of benefits and enhanced service delivery

Monitored and analyzed recurring member issues, contributing valuable insights for process improvements and policy updates in Medicare service operations

Facilitated seamless Medicare benefits coordination among healthcare providers and internal teams, reducing resolution time and enhancing member experience

FINANCIAL COUNSELOR (TEMP CONTRACT) Feb 2023 - May 2024 Rothman Institute Philadelphia, PA

PRE-REGISTRATION SPECIALIST (FINANCIAL COUNSELOR) Aug 2022 - Jan 2023 University of Pennsylvania Health System Philadelphia, PA RESIDENTIAL MONITOR TECHNICIAN Feb 2020 - Aug 2022 Self Help Movement Inc Philadelphia, PA

PART-TIME SORTATION ASSOCIATE Jun 2019 - May 2020

Amazon Logistics Delivery Station DEW4 Langhorne, PA Guide patients on financial obligations, boosting satisfaction and transparency. Coordinate with billing to resolve claims, enhancing payment efficiency. Facilitate events for cost clarity, aiding informed patient decisions. Verify benefits and secure authorizations, improving patient care access. Collect service payments, ensuring timely revenue collection. Maintained comprehensive financial records and payment tracking systems, ensuring accurate documentation and compliance with healthcare billing protocols

Implemented strategic payment collection procedures for self-pay services, contributing to improved cash flow and reduced outstanding balances

Streamlined patient financial consultations through clear communication protocols, resulting in enhanced understanding of payment obligations and increased satisfaction rates Verify patient financial details pre-service, ensuring accurate coverage and compliance. Facilitate payment plans, enhancing patient satisfaction and financial accessibility. Collaborate with financial staff to assist uninsured patients, improving care access. Communicate with payers to confirm coverage, optimizing financial clearance. Guide uninsured patients through financial aid, ensuring healthcare access. Orchestrated payment arrangements and benefit explanations with patients and insurance providers, fostering transparent communication and improving collection rates

Streamlined pre-service financial verification processes, ensuring accurate insurance coverage validation and reducing registration delays

Ensured 24/7 building security, coordinating shift transitions seamlessly. Monitored surveillance for safety, addressing issues promptly. Managed front desk operations, fostering a welcoming environment. Documented resident concerns, enhancing communication efficiency. Maintained confidential records, ensuring compliance with regulations. Monitored comprehensive security systems and conducted hourly facility inspections, maintaining incident-free environment and ensuring resident safety protocols were consistently followed Coordinated front desk operations including visitor management, resident sign-ins, and conflict resolution, fostering a welcoming atmosphere while upholding facility security standards Developed streamlined documentation processes for incident reporting and resident concerns, enabling effective communication across shifts and improving response times Established robust communication channels with community resources and funding agencies, enhancing care coordination and support services for residents

Handled packages up to 49 lbs, ensuring efficient sorting and delivery. Operated moving equipment to streamline merchandise handling. Received and sorted orders for timely shipment preparation. Built and transported pallets, optimizing warehouse operations. Orchestrated accurate package classification and routing across multiple sorting stations, ensuring proper destination alignment and reducing delivery errors

Streamlined pallet building and wrapping processes to optimize storage space utilization and enhance warehouse efficiency SSD REPRESENTATIVE (TEMPORARY CONTRACT) May 2018 - Jun 2018 ETS Ewing, NJ

QUALITY ASSURANCE SPECIALIST (TEMPORARY CONTRACT) Dec 2015 - Feb 2016 Harte Hanks Langhorne, PA

CALL CENTER AGENT Aug 2012 - Aug 2013

Sykes Enterprises Langhorne, PA

EDUCATION

HIGH SCHOOL DIPLOMA Sep 2004 - Jun 2008

Emily Fisher Charter School of Advanced Studies Trenton, NJ BACHELOR IN BUSINESS Jan 2009 - May 2017

University of Maryland-College Park College Park, MD COURSES

CPR & FIRST AID Apr 2021 - Present

Various

BASIC HIV Feb 2020 - Present

Various

SKILLS

Customer Service, HIPAA, SAP, Microsoft Office, Data Entry, Insurance Verification, Medical Billing, Quality Assurance, Documentation, Problem Solving, Communication, Conflict Management, Financial Analysis, Patient Care, Healthcare, Administrative Support, Case Management.

LANGUAGES

English (Native), Spanish (Proficient).

Confirmed AP-level test booklets for incoming freshmen, ensuring accuracy and compliance. Utilized SAP SD for efficient management of test booklet logistics nationwide. Conducted manual verification of school codes and test numbers, confirming data via MS Excel. Collaborated to ensure timely distribution of educational materials across the U.S. Enhanced accuracy in test booklet handling, contributing to seamless operations. Validated AP-level test materials and booklets using dual-verification system, ensuring accuracy in academic placement processes for incoming freshmen

Evaluated phone enrollments to ensure compliance and accuracy. Reviewed and completed missing insurance applications. Utilized SAP for precise billing verification.

Enhanced application processing efficiency.

Contributed to improved customer satisfaction.

Evaluated phone enrollment conversations and BCBS applications with precision, ensuring compliance with quality standards and reducing processing errors

Conducted thorough audits of PDF documentation, identifying and rectifying missing information to maintain complete and accurate enrollment records

Handled 60+ daily calls on Nikon products, ensuring customer satisfaction and efficient issue resolution. Managed 50+ emails daily, maintaining high response accuracy and customer engagement. Utilized SAP for tracking shipments, optimizing distribution processes and inventory management. Resolved complex technical inquiries about Nikon products, delivering comprehensive solutions while maintaining professional customer relationships

Streamlined call handling processes to reduce average response time while maintaining high customer satisfaction levels Coordinated with distribution center teams to expedite shipping inquiries and resolve delivery challenges, enhancing overall customer experience

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