Call Center Service Representative

MELISSA WILFORD

Independence, MO 816-***-**** **************@******.***

Professional Summary

Empathetic and experienced Customer Service Representative with over 10 years of experience in fast-paced healthcare call centers and administrative environments. Proven ability to handle 70+ calls daily while maintaining high standards of professionalism, empathy, and first-call resolution. Skilled at managing multiple systems, resolving complex issues, and communicating clearly with members, providers, and pharmacies. Proficient in Microsoft Office, Epic, Kronos, and Workday. Committed to delivering a positive customer experience with attention to detail and strong organizational skills.

Key Skills

• High-Volume Call Center Support & PBM Experience

• One-Call Resolution & De-escalation

• Multisystem Navigation & Data Entry (65+ WPM)

• Pharmacy/Benefits Inquiries & Claims Research

• Microsoft Outlook & Office Suite

• Verbal and Written Communication

• Conflict Resolution & Customer Retention

• Remote Work Setup & Time Management

• HIPAA Compliance & Patient Confidentiality

Professional Experience

Remote Call Center Agent

Advanced Call Center Technologies, LLC – Berwyn, PA Jan 2022 – Nov 2024

• Handled 70–80 inbound calls per day from members and providers regarding benefits and claims.

• Used multiple systems simultaneously to verify benefits, research issues, and resolve complaints.

• Delivered compassionate, solutions-focused service for pharmacy, billing, and general inquiries.

• Escalated unresolved issues appropriately while ensuring thorough documentation.

• Participated in 100% of training sessions and adapted quickly to policy/system updates.

Patient Care Coordinator

Vitas Healthcare – Miramar, FL Mar 2021 – Jul 2021

• Managed high volumes of incoming patient and family calls regarding services and insurance coverage.

• Provided clear cost estimates and collected patient payments by phone with empathy.

• Tracked service activity through EHR systems and ensured timely coordination of care.

• Maintained strict HIPAA standards while updating records and processing requests.

Information Associate Supervisor / Patient Care Technician II

Saint Luke's Health System – Kansas City, MO Apr 2002 – Jan 2021

• Supervised administrative staff and handled patient-facing inquiries both in person and via phone.

• Researched and processed patient and insurance refunds, explaining benefits and billing statements.

• Used Epic and Kronos for patient scheduling, billing, and medical record documentation.

• Ensured top-tier service to patients in a diverse hospital environment while managing multiple priorities.

Education

High School Diploma – Hickman Mills High School, Kansas City, MO

College Coursework – Medical Training – Sanford Brown College, North Kansas City, MO

Certifications

• Medical Billing & Coding – University of Central Missouri

• Certified Nursing Assistant (MO, KS, FL)

• Patient Care Technician / Phlebotomy – Saint Luke's Hospital

• Remote Work Certification – Work Place Less

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