Customer Service Representative
Resume:
Kivalina Grande
Beavercreek, OH *****
********.******@*****.***
Authorized to work in the US for any employer
Work Experience
Client Advisor
RetireMedIQ - Miamisburg, OH
August 2022 to Present
Licensed Medicare insurance agent. Assisting current clients with switching from a Medicare supplement to an advantage plan. Provides information to client about the benefits and costs. Does cost/benefit analysis to provide client with the best plan for them. Maintains organized work area, files and appointment preparation. Keeps accurate documentation and follows up with clients accordingly Claims Representative
Heartland health and wellness - Vandalia, OH
February 2022 to April 2022
Assisted in filing claims for members in a third party insurance company for union members. Kept track of new members, assisted members with questions and used various software to assist. Had to leave due to a medical issue
Member Advocate
Humana - Work at Home - Beavercreek, OH
October 2021 to February 2022
Took inbound phone calls from members. Used resources to answer member questions and investigate and solve their problems. Have excellent customer service, used multiple systems and maintained concurrent documentation. Looked up procedures and quoted prices based on cpt codes Claims Specialist
Dayton Gastroenterology - Beavercreek, OH
April 2021 to September 2021
Examined claims, properly attached insurance. Researched eligibility on Medicare.gov, medicaid, etc. Sent delinquent accounts to collections, made sure claims were properly coded with the proper ICD-10. CSR - Customer Service Representative
CareSource - Kettering, OH
August 2020 to April 2021
• Assisted customers with a warm and professional attitude
• Assisted customers with questions
• Kept records of customer complaints
• Handled emails, inbound calls, and outbound calls
• Managed customer accounts
• Monitored claims and physician-related services
CSR - Customer Service Representative
synchrony - Kettering, OH
March 2020 to July 2020
• Assisted customers with a warm and professional attitude
• Assisted customers with questions
• Handled emails, inbound calls, and outbound calls
• Managed customer accounts
• Handled billing issues and order inquiries
CSR - Customer Service Representative
Victoria's Secret - Kettering, OH
August 2019 to January 2020
• Assisted customers with a warm and professional attitude
• Handled emails, inbound calls, and outbound calls
• Managed customer accounts
• Handled billing issues and order inquiries
Patient Care Technician
DaVita Dialysis - Kettering, OH
January 2016 to September 2016
• Prepping and priming the dialysis machines
• Taking vitals of patients and making sure they were within the proper values every 15 minutes
• Administering heparin, saline solution, and first aid if necessary
• Maintaining proper documentation and paperwork following all procedures and vitals
• Knowledge of all water systems, doing water checks and maintaining proper documentation
• Keeping track of supplies, and noting when supplies needed ordered Relevant Employment:
inventory management
Meijer Pharmacy - Kettering, OH
April 2015 to October 2015
Kettering, OH April 2015 - Oct 2015
● Receiving and processing prescriptions, accurately filling prescriptions, customer service, handling insurance issues, obtaining prior authorizations, inventory management; organizing the drugs and filing finished prescriptions and paperwork.
● Handling medicare audits, doctor call queue and the third party call queue. I was very proficient with our computer system, EPS and could handle a wide array of insurance issues.
● Possessed a good knowledge of medications, their uses and methods of action. I often went above and beyond for the patient. If we did not have a medication in stock, I would see if another store in our network had it, and when we could get it by. Several times, I drove to other stores to pick it up myself. I always enjoyed helping do what was best for the patient and meeting their needs as quickly as possible. I have also worked at a few other Meijer stores in different areas that I have lived in, as well as a Kroger pharmacy and at mail order Express Scripts.
Other Employment:
Donor Specialist
Community Blood Center - Dayton, OH
June 2013 to November 2014
Assessing a potential donor's questionnaire and using the appropriate follow up questions as needed to determine eligibility. After the questions were concluded, I would then take the donor's vitals, and perform a capillary stick to run a hematocrit test.
● Using standard precautions, I did an arm prep and a venipuncture with a 16 gauge needle. An average donation was between 8 and 12 minutes. During this time, I would monitor the donor for comfort and any signs of a reaction. If a reaction did occur, proper first aid was immediately administered.
● Blood bags were carefully doubled checked and labeled. Other duties included set up and break down of mobile blood drive equipment, team work within the "pod" and registration at the front desk. Friendliness and quick thinking were necessary skills to have.
I handled all nurse draws
Good Samaritan Hospital - Dayton, OH
April 2011 to June 2013
Dayton, Ohio April 2011 - Jun 2013
● Began working with client services, going to nursing homes, collecting specimens and returning them to the lab to be processed. I then would return to the floor and hook on to the first shift rotation.
● Became a specimen processor as well as working the floor sometimes. As a specimen processor, I handled all nurse draws, er draws, all fluids, called back test results, monitored phlebotomy draw progress, centrifuged specimens and distributed to proper work benches
● Experienced a wide variety of patients. I drew patients on every floor, including ICU, ER and mental health. I worked with geriatric, bariatric, very critical, combative, and stroke alerts. I also got experience in outpatient at the main campus, as well as Good Sam North. Did not get experience with pediatric patients, but did do heel sticks on newborns.
Education
Certificate
Sinclair Community College - Dayton, OH
April 2015
Certificate
Sinclair Community College - Dayton, OH
April 2011
Certificate
Sinclair Community College - Dayton, OH
April 2011
Certificate in Pharmacy Technician
Sinclair Community College - Dayton, OH
May 2010
Bachelor of Science in Nursing
Wright State University - Dayton, OH
Skills
• CUSTOMER INTERACTION (Less than 1 year)
• ETIQUETTE (Less than 1 year)
• EXCELLENT PHONE (Less than 1 year)
• PHONE ETIQUETTE (Less than 1 year)
• SELF MOTIVATED (Less than 1 year)
• Dialysis Experience
• Pharmacy Technician Experience
• Venipuncture
• Laboratory Experience
• Vital Signs
• Phlebotomy
• Experience Administering Injections
Certifications and Licenses
CPR Certification
Additional Information
Other skills:
● Friendly, and able to work with patient/customer to solve problems in a timely manner
● Excellent phone etiquette
● Communicate clearly and concisely
● Follow directions well
● Self motivated
● Enjoy working in a very orderly and concise fashion.
● Enjoy patient/customer interaction and working in a team as well as independently.
● Skilled with using various computer programs
Contact this candidate