Customer Service Contact Center
Resume:
Danielle Burke
N Las Vegas, NV *****
*****************@*****.***
Professional Summary
With over 9 years of remote work experience in contact center environments, I bring a proven track record of excellence in customer service and operations. My deep industry knowledge, paired with exceptional communication skills, allows me to manage high volumes of interactions efficiently and effectively. I am committed to delivering outstanding service, solving problems proactively, and contributing meaningfully to team and organizational goals.
Work Experience
Medicare Appeals Processor
Acentra Health-Remote
December 2024 to Present
• Handle 30–40 daily inbound calls from Medicare beneficiaries, providing guidance and support for filing first-level appeals and reconsiderations.
• Accurately input and process appeal requests in compliance with Medicare guidelines and organizational procedures.
• Communicate with healthcare providers and insurance carriers to notify them of appeals, and coordinate the retrieval of medical records via fax requests.
• Review appeals related to Medicare coverage decisions to determine eligibility and compliance; escalate complex or clinically sensitive cases for advanced clinical review when necessary.
• Ensure timely and accurate documentation while maintaining a high standard of customer service and regulatory compliance.
Eligibility Specialist Contact Center Representative Centauri Health Solutions-Remote
February 2024 to July 2024
• Conducted phone interviews with patients and members to gather personal and sensitive information necessary for assessing eligibility for various federal and state government assistance programs.
• Clearly explained program requirements, application processes, and eligibility criteria to ensure understanding and compliance.
• Compiled, recorded, and evaluated personal, financial, and household data to make accurate eligibility determinations.
• Maintained confidentiality and adhered to HIPAA and other regulatory standards while handling sensitive information.
• Provided empathetic and solutions-oriented support to diverse populations, often navigating complex personal and financial situations.
Healthcare Service Representative
Tential Temporary Employment Services-Remote
January 2023 to June 2023
• Delivered comprehensive healthcare support through inbound and outbound calls, assisting patients with appointment scheduling, specialist referrals, provider changes, and prescription refill requests.
• Utilized Electronic Medical Records (EMR) systems to accurately manage patient information, coordinate care, and ensure timely service delivery.
• Collaborated with clinical and administrative teams to streamline workflows and enhance the patient experience.
• Maintained HIPAA compliance and patient confidentiality while handling sensitive medical and personal information.
• Demonstrated strong multitasking and problem-solving skills in a fast-paced, high-volume contact center environment.
Medical Billing & Scheduling Coordinator
Parallon HCA-Hospital Services-Remote
July 2021 to November 2022
• Managed and updated patient charts by processing current and aged Explanation of Benefits (EOBs), ensuring timely and accurate payment collection.
• Utilized Electronic Medical Record (EMR) systems, including Meditech and Epic, to maintain and access patient records and billing information.
• Coordinated and maintained complex procedural schedules across multiple hospital locations, ensuring efficient resource allocation and minimizing scheduling conflicts.
• Collaborated with healthcare providers, billing departments, and administrative teams to streamline processes and improve patient service delivery.
• Maintained strict confidentiality and compliance with HIPAA regulations throughout all aspects of billing and scheduling duties.
Health Insurance Member Services Representative
GetInsured-Call Center-Remote
October 2020 to June 2021
• Provided accurate and easy-to-understand information to members regarding health insurance plans under the Affordable Care Act (ACA), including enrollment, coverage options, and eligibility.
• Delivered high-quality service through phone and online chat support, ensuring a positive and informative experience for every member interaction.
• Assisted with troubleshooting account issues, clarifying benefits, and guiding members through complex application and renewal processes.
• Maintained up-to-date knowledge of ACA policies and plan details to ensure compliance and accurate communication.
• Documented all interactions in internal systems with attention to detail, following privacy and HIPAA guidelines.
Customer Support Representative – Roadside & Technical Assistance LiveOps-Call Center-Remote
December 2017 to February 2021
• Responded to inbound customer calls to diagnose and resolve a variety of technical issues, ensuring quick and effective solutions.
• Provided real-time support and guidance for customers experiencing vehicle-related problems, escalating cases when necessary.
• Coordinated with third-party vendors such as towing companies and tire services to deliver timely roadside assistance.
• Maintained detailed records of service interactions while adhering to company protocols and delivering a high standard of customer care.
• Demonstrated calm and professionalism in high-stress situations, ensuring customer safety and satisfaction.
Customer Service Representative – Automotive Services TouchPoint Contact Center-Remote
September 2019 to April 2020
• Handled high-volume inbound calls to schedule appointments, resolve service issues, and manage customer account information accurately and efficiently.
• Coordinated the release and relocation of vehicles to designated locations, ensuring smooth operations and timely service delivery.
• Provided support via live chat, promptly addressing customer inquiries and resolving concerns to ensure a positive service experience.
• Maintained detailed records of customer interactions and service requests, ensuring data accuracy and follow-up compliance.
• Delivered responsive and empathetic service in a fast-paced environment, contributing to customer satisfaction and retention.
Global Concierge & Customer Support Specialist
Aspire Lifestyles-Citi Bank-Remote
February 2019 to August 2019
• Delivered personalized global customer support by coordinating travel arrangements, booking events, and securing restaurant reservations and other specialized services.
• Served a diverse clientele with high attention to detail, discretion, and professionalism, often managing time-sensitive or high-priority requests.
• Maintained strong relationships with vendors and service providers to ensure seamless experiences for clients across various regions and time zones.
• Demonstrated cultural sensitivity, resourcefulness, and adaptability to meet the unique needs of international customers.
• Consistently met or exceeded service quality standards, contributing to high customer satisfaction and loyalty.
Customer Service Representative – Product Support & Order Management Williams Sonoma, Inc.-Remote
August 2017 to January 2018
• Managed inbound customer inquiries and concerns related to product availability, delivery status, and order processing.
• Provided detailed product information and recommended alternative solutions when items were out of stock to maintain customer satisfaction.
• Processed orders accurately while adhering to company policies and ensuring timely fulfillment.
• Utilized negotiation and conflict resolution techniques to effectively address and resolve customer issues, fostering positive relationships and repeat business.
• Maintained accurate records of interactions and transactions, supporting seamless customer service operations.
Education
Other in Medical Billing & Coding
Northwest Career College-Las Vegas, NV
May 2024 to Present
GED in General Studies
Sheepshead Bay HS
September 1999 to November 1999
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