Customer Service Representative

FRANKIE LEONA BRISCOE

*** ****** ** *****

Mobile: 210-***-****

****************@*****.***

Summary

Skilled inbound Customer Service committed to addressing customer concerns with

speed, accuracy and professionalism.

Resourceful Customer Service representative who consistently meets and

exceeds productivity goals through resourcefulness.

Customer-focused Representative with a proven capacity to troubleshoot

issues to ensure customer satisfaction. I always

take the extra step and practice follow-up

Highlights

High customer service standards Computer Literate

Employee relations specialist Html and Java educated

Service solutions expert Experienced with Power Point

Accomplishments

Managed call flow with up to 20 calls in queue per minute.

Exceeded corporate target for customer satisfaction for 5 months in a

row.

Promoted to middle management handling escalated calls and teaching other

representatives navigation and problem handling.

Received numerous complimentary calls throughout the years.

Asked by upper management to partake in an employee representative

resource that directs the employees concerns to upper management called the Voice

Committee. Created a "Did You Know" employee/management problem solving newsletter

and dialogue team with Aetna.

Awarded a plaque by Aetna’s Vice President (now President) Mark T.

Bertoloni for suggesting cross training between departments to

reduce call transfers.

Treasurer of the Aetna LGBT Resource Committee for 2 years

Experience

Short Term Contract Employment

2023 to 2024

MMC contracting for Conduent

Handling calls for assistance with EBT, WIC, TANF, account information and escalations

2022 to 2023 Robert Half customer service representative for Centene working Medicaid, taking calls

from providers verifying benefits and physicians on file; explaining claims and billing to provider.

2021

Addeco customer service 6/2021 to 11/2022

CDC Call Representative In bound calls needing locations for Covid Vaccinations Customer Service for

Verizon Inboound calls assisting callers with their designing their plans and explaini ng their plan. Okin

sending hospital beds and equipment to hospitals

Alorica Call Center 8/2017 to 12/2020

Responsibilites

Inbound emails, outbound sales,for Waste Management, Directv, Bank of America, and Goldman Sachs

United Health Care 08/2015 to 7-03-2017

Concierge Customer Service Claims

Responsibilities

inbound call for claim disputes and discrepancies

escalated for claim adjustments

knowledge of medical coding

explain invoice billings

contacted providers and third party administators on benefit

coverage discrepancies

verified eligibilty

sent letters of acknowledgement for active coverage and terminations

explained plan changes

provided in and out of network providers contact information

gave test claim information on copay and deductibles

CVS

(Pharmacy Call Center for Aetna sold to CVS and the following updates those duties with the new company)

Customer Service Representative II 06/2012 to 07/2015

San Antonio, TX

Pharmacy claims issues orders and inquiries. Coverage copays deductibles plan limits.

Assisted other representatives in call handling, software training and escalated calls.

Claim resolution

Aetna San Antonio, TX

Customer Service Representative I 02/2005 to 06/2012

Received Call from customers to place orders, check order status, explain

their pharmacy benefits. Explain delays and

rejects. Provide alternatives and resources when issue was outside of my pervue.

Provided accurate and appropriate information in response to customer inquiries.

Demonstrated mastery of customer service call script within specified time frames.

Made reasonable procedure exceptions to accommodate unusual customer

requests.

Developed effective relationships with all call center departments

Maintained up-to-date records at all times.

clear communications theme

Certificates

HealthMarkets Insurance

Agent 5-5-2017

Calling shared leads for health and medicare coverage.

Creating warm market. Doing presentations

Producer License Certificate for

Life, Health, Accident State of Texas

expired 9-15-2019

Education

UDEMY online

Certificate of Learning in Medical Terminolgy

Certificate of Learning in Anatomy and Pathology

Certificate of Learning in Medical Billing

Presently studying Medical Coding CPT

UCLA Los Angeles, CA, USA

Bachelor of Arts: Fine Arts UCLA

Texas Wesleyan University

Law No degree

1998-2000 Fort Worth, TX, USA

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