Customer Service Representative
Resume:
VALERIE COUCH
**** ****** ***** ***. #**, Sacramento, CA 95841
**************@*****.***
Objective
To obtain a position where I am able to build and expand on the experience and knowledge that I possess.
EXPERIENCE
Western Health Advantage
May 2023 – Mar 2025
Member Services Representative
1)Contact for member and providers regarding coverage questions, medication approvals, benefits and provider changes.
2)Assisted with yearly enrollment of new members.
3)Updated patients demographics in computer systems.
4)Entered and routed complaints to correct department .
5)Verified provider assignments, eligibility and assisted in coverage verification for members as requested.
6)Problem solving as needed.
WellSpace Health
October 2022 – February 2023
Call Center Representative / Patient Liaison
1)Point of contact for patients, hospital staff and case managers to schedule
1)appointments with providers at desired location.
2)Forward requests for referrals, medication refills and provider contact.
3)Updated patients demographics in computer systems.
4)Entered new patient information into computer system.
5)Verified insurance assignment, payer and eligibility.
6)Problem solved as needed.
Health Net Federal Services
June 2013 to May 2021
Customer Service Representative II
1)Answered incoming calls regarding health care concerns, enrollment, demographic changes, PCP changes in the military database.
2)Processed enrollment fees for active duty members and families.
3)Processed urgent need referrals, authorizations and escalated issues.
4)Performed extensive provider searches.
5)Worked in conjunction with Military base clinics for patient Healthcare.
6)Updated patients accounts in the Military database with all changes.
7)Assisted with training of new hires.
8)Problem solved as needed.
HomEq Serving aka The Money Store
June 1998 to September 2010
Customer Service Representative/Claims Representative II
Front Range Collection/Customer Service/Hazard Claims/Escrow
1)Contacted home owners regarding delinquent accounts.
2) Set up repayment plans per company policies.
3) Cleared delinquencies off of year end totals.
4) Reviewed special contracts in bankruptcy and foreclosure.
5) Answered incoming calls and routed to correct departments.
6) Processed hazard claim to properties. Deposited claim checks and dispersed as repairs were being completed.
7) Applied received funds to outstanding loans as needed/ requested.
8) Ordered property inspection to verify work/repairs as being completed.
9) Processed escrow payments per contract.
10) Processed overage checks and mailed to property owners.
EDUCATION
MTI Vocational College in Medical Assisting / Phlebotomy 4.0 GPA
AWARDS AND ACKNOWLEDGEMENTS
Recipient of numerous company awards and patient/member accolades.
Appeared on President’s list repeatedly for attendance and grades during scholastic term.
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