Customer Service Help Desk
Resume:
SUMMARY
Administrative/customer service professional with over 20 years hands-on experience providing administrative support, skills, and training in various fields of the healthcare industry. My extensive knowledge and training allow me to develop different techniques and strategies which I use to perform my daily task efficiently as well as contribute to the company's success by providing the highest level of service.
Contact
******************@*****.***
863 Southwest 38th Street
San Antonio, TX 78237
Qualification
Problem analysis problem solving critical thinking adaptability – ability to work under pressure. People oriented ability to establish and maintain client relations. Strong work ethics, positive attitude, active listening, empathetic ensure effective clear. Language and understanding management -- organize and. Prioritize initiator- utilizes strategic tactics to target specific milestones to achieve overall goal dedicated- to the needs of the consumer and company excellent communication skills- negotiation
Education
Associates Of Applied Science, Medical Administration
Career Point College,
San Antonio, Texas
SAN ANTONIO COLLEGE
AUGUST 2011 TO JULY 2014
32 CREDIT HOURS
Key job skills
Customer service outbound and inbound, billing and coding claims processing, front office management, benefits advocate,
Intake coordinator, admissions, authorizations specialist,
Referral coordinator, and office coordinator
Experience
CGI FEDERAL – MMC Group
Help Desk Analyst Tier 1
May 2024 to August 2024
March 2025 to April 2025
Provide T1 Help Desk Support for Center for Medicare and Medicaid Perform analysis to review client issues Resolve day-to-day production requests and issue accurate, grammatically correct analysis and resolution responses within the expected window. Worked closely with the internal team members, product owners, and agency staff to address reported issues and concerns into workable solutions Develop Momentum application knowledge, to include its operating environment and its external dependencies Support AOC with the following systems: I&A IBM PECOS, NPPES Used AOC’s Create ticketing system in addition to CGI’s JIRA to create, track, and resolve tickets Support AOC via phone and email support Update the LBFMS Confluence with updates and changes to procedures and walkthroughs Attend AOC and CGI team meeting.
Wells Fargo- Randstad
You will work as a Customer Service Rep with Wells Fargo Consumer Lending and will be responsible for providing quality customer experience while working to resolve customer’s complaints/enquiries.Researching cases independently Types of calls include: Payments, lost/stolen cards, dispute, fraud, transaction review, digital options, balance transfers Responsible for reviewing the customer’s credit card profile, payments, reviewing accounts, assisting the customer understand their balances Inbound Call Center: 75-100 calls per day (higher volume calls in the earlier shifts) Calls around 3-5 minute approximately Calls are back to back and sometimes a breather in between calls Will transfer more escalated calls to another department At desk all day long- expectation to stay at desk Can be loud and busy Resource utilization System navigation is important skill Understanding toolbars Organizing desktop Use multiple windows Navigate when talking to customers Average amount of calls and AHT Average 75-100 calls a day Calls are 3-5 minutes approximately Calls can be back-to-back and sometimes there’s a breather in between.Based on call volume there could be opportunities for overtime or time off without pay
Alorica
Training Manager / Customer Service Representative / Collections
August 2021 To February 2024
I was responsible for conducting orientation programs and arranging on-the-job training for new hires and developing learning and developmental strategies in which assess the skills, performance, productivity, and talents of employees. I prepared written evaluations with advice for improvement. Identified future training needs and created A curriculum to facilitate training. Lead programs to assist employees with transitions due to technological changes, acquisitions, and mergers. I communicated with management, trainers, and team members to ensure that all needs are met. Resolved any specific problems and tailored training programs, as necessary.
Allstate Insurance
Claims Specialist
04/ 2018 To 04/2019
Under direct supervision, this job provides support to claim personnel through A variety of non-complex, routine tasks. The individual is expected to deliver compassionate service that is fast, fair, and easy, to ensure customer retention. Admin support performs clerical duties, including data entry, filing paper documents, email, calendar management, and word processing retrieves, prints, and faxes, or mails supporting documentation to vendors or others as directed process, sort, index, and route incoming and outgoing communications related to claim operations receive, screen and route telephone calls and other electronic correspondence
Centene Corporation
Customer Service Representative II
08 /2017 To 04/2018
Responded to all inbound and outbound calls in A timely and professional manner. Resolved customer conflict by identifying the issue and finding the best practical option or solution. Assisted members with inquiries on benefits, eligibility, claims, billing, and payments by researching claims issue and appropriately escalated as necessary, ensure the correct benefits were being applied by researching and correcting any incorrect payments, gathered any missing information. Served as A liaison by organizing, communicating, coordinating, between all entities to achieve the best utilization of resources. Clarified any concerns or questions about explanation of benefits (EOB), flexible spending accounts and correspondences. Used probing questions while listening actively and documenting required information, referencing CMS/ Medicare benefits plan documents. Intervene with care providers (doctors’ offices) on behalf of the customer to assist with appointment scheduling, transportation arrangements, and any other tasks necessary to ensure the highest level of service care. Escalated all grievances to appropriate branch. Appropriate closing response
United Healthcare PPO Commercial
Benefits Advocate / Claims Specialist
06/2015 to 07/2017
Responded to inbound and outbound calls by answering and resolving any issues questions concerns. Improved the lives of our members promoting wellness programs as A preventive measure to prevent illness, control, and manage conditions or disease. Answered questions, and resolve issues regarding health care eligibility, claims and payments, eligibility, EOB’s precertification, authorizations referrals, correspondences and or financial spending accounts by researching all plan documents ensuring proper benefits are being applied, gathering any missing information, correcting any errors. Communicating and intervening with primary care physicians on behalf of members. Reviewing, researching, and processing healthcare claims. Adjusted claims as needed, corrected any incorrect payments. Research complex issues across multiple databases and support resources refer unresolved customer grievances to designated departments for further investigation. Accurately entered all documentation with great attention to detail eliminating any errors, provided worked independently and manage one's time efficiently ensuring all deadlines and timely filing were met.
Christus Santa Rosa Children's Hospital Of
San Antonio Specialty Clinic
Office Coordinator
10/2009 To 02/2014
Facilitated all referrals and authorizations for medical services rendered. Registered all new patients into the system. Check in and outpatient. Insured all appropriate forms were completed. Obtained patient demographic and insurance information. Collected copays, deductibles, copays, and any out-of-pocket fees at time of patient visit. Managed physician and clinician schedules, appointments, and correspondences. Provided front desk support, greeted patients in A courteous and professional manner, provided information as asked, explained all financial aspects to patients. Respond to requests for information and referrals from parents and other professionals. Complete all tasks in A timely manner. Obtained required documentation and reports. Gather appropriate documentation including insurance verification, authorizations, and pre certifications. Keep patient informed on status of referral. Work collaboratively in A team environment. Maintain confidentiality. Performed other job duties as assigned, answered phones, followed up with patients, confirmed appointments, and maintained medical records.
San Antonio Clinical Genetics
Front Office Manager
10/2009 To 02/1014
Managed office productivity, coordinated referrals from other physician offices or specialists, coordinated all genetic testing by initiated authorizations of specific laboratory and diagnostic testing. Managed physician schedule, appointments, and correspondence maintained patient medical records. Greeted patients and visitors in A courteous and professional manner. Collected copays, deductibles and coinsurance, answer telephone and respond to inquiries, responsible for patient scheduling, verified insurance benefits for patient, conducted reminder calls to all patients, reviewed patient charts to make sure all information was up to date, reviewed and processed EOB’s. Entered all fee tickets in to billing system. Ensure accuracy of claims and billing fees.
Contact this candidate