Customer Service Office Manager
Resume:
**************@*****.***
Timmonsville, South Carolina
SHUSHELIA
JEFFERY
EDUCATION
Associates: Business Management
Centura College – Florence, South Carolina
Certification: Accounting
Poynor Adult Education – Florence, South Carolina
CAREER EXPERIENCE
SUBSTITUTE TEACHER
Florence School District One December 2023 – Present Florence, South Carolina
• Report to the office upon arrival, check mailbox of absent teacher for materials requiring immediate attention, and request clarification of school rules and procedures when necessary.
• Integrate lesson plans and materials that are most appropriate for meeting lesson objectives in the teacher's absence and write reports about uncontrollable students with noncompliant behavior.
• Institute effective behavior modification techniques while using appropriate judgment to act in the best interest of students at all times and reinforce positive behavior to sustain a calm and controlled classroom.
• Tutor and assist students individually or in small groups to help master assignments and learning concepts. OFFICE MANAGER
Tender Care Home Healthcare October 2014 – November 2023 Florence, South Carolina
• Investigated claimant eligibility status for Short-Term Disability claims, reviewed contracts and medical documentation to ensure that all claims were competently handled within an appropriate timetable.
• Processed medical claims, monitor medical bills for errors, negotiated settlements with policyholders and third parties to achieve fair resolutions, and authorized the payment of medical claims.
• Communicated with customers and physicians for requested information to facilitate the outcome of the evaluation while maintaining compliance with HIPAA.
• Completed bookkeeping records for all accounts for payment and prepared computer spreadsheets for billing and record keeping purposes.
CUSTOMER SERVICE MANAGER
ATH Power Consulting Services October 2013 – October 2017 Florence, South Carolina
• Implemented customer service policies and procedures and communicated all reports to understand and promote work productivity improvements and maintenance of customer service levels.
• Forecasted monthly and annual sales targets including profit margins to guarantee attainment of projected goals.
• Mentored remote teams effectively through continuous training and professional development programs by overseeing risk management practices to ensure compliance with regulatory standards.
• Assisted with card services, provided account opening information, notated accounts, and customer facing technology issues such as online banking, mobile banking, and telephone banking. RECORDS CLERK/CLAIMS EXAMINER
Blue Cross Blue Shield of South Carolina June 2003 – September 2013 Florence, South Carolina
• Acknowledged the concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best practices.
• Organized and maintained the record system including necessary filing, updating, restoring, and retrieving records in accordance with policies and procedures.
• Collaborated with cross-functional teams to utilized advanced data analytics to identify and prevent fraudulent claims.
• Conducted inspections using collaboration technologies and digital platforms that lead strategic initiatives to improve customer satisfaction and service delivery and increasing accuracy by 30%. Client Assessment & Evaluation
Customer Relationship Management
Case Management Documentation
Claims Analysis & Investigation
Quality Assurance
Process Improvement
Project Management
Account Reconciliation
Team Leadership
Effective Communication
Cultural Competence
Conflict Resolution
Time Management
Compliance Regulatory
Electronic Health Records
EXPERTISES
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