Customer Service Center Representative

Cordeania Evonn Knox

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

Riverview, FL 33579

Cell: 813-***-****

Email: ************@*****.***

Seasoned Customer Service Professional with over 26 years’ experience bridging gaps and building relationships to deliver an exceptional customer experience. Proven organizational and administrative expertise. Consistent success in meeting organizational goals for efficiency, accuracy and effectively identifying risks. Outstanding interpersonal skills and proven ability to work effectively as part of a team and maintaining excellent attention to detail. Mature values and polished professional image coupled with excellent verbal and written skills support my ability to achieve results.

PROFESSIONAL EXPERIENCE

CWP Inbound Contact Center Representative 2

Humana Tampa, FL November 2022 – Present

Performs varied activities and moderately complex administrative, operational customer support assignments, and computations on a semi-routine basis.

Addresses customer needs to include resolving complex benefit questions, issues with order management and processes while educating members.

Records details of inquiries, enters comments and/or complaints in feedback systems, tracks transactions or interactions and takes action in accordance to established policies and procedures.

Escalates unresolved and pending customer grievances per CenterWell Pharmacy guidelines.

Interprets departmental policies and methods for completing assignments.

Works within defined parameters to identify work expectations and quality standards, with some of the latitude self-prioritization or timing under minimal supervision.

Follows standard policies and practices' that allow limited interpretation, deviation and independent discretion.

Bank Sales and Service Contact Center Representative I

Full-Time 40 hours per week

USAA Tampa, FL April 2019 - March 2022

Provides member onboarding, servicing and/or facilitation of product sales in a call center.

Assists with facilitating the financial security of both members and their families through needs-based assessment via sales or service conversations about credit card servicing, consumer lending or complex titles.

Deepens and retains relationships with members through living room conversations that garners member trust and offers USAA products and services solutions that meet their needs.

Adheres to applicable federal and state laws and technical requirements established through USAA policies and procedures in a consistent and compliant way through risk-based assessment of business activities that are pre per weekdefined for my role.

Reports are identified risks through daily job performance to manager and risk process owners to measure, monitor and control risks to ensure compliance.

Follows all KC procedures for customer service activities for credit card dispute servicing and sets members expectations.

Successfully demonstrates ability to resolve conflicts with members who are unsatisfied with dispute resolutions and transactions through conflict resolution management and empathy.

Documents members' concerns and requests to submit additional information in DCC.

Program Support Assistant

Full-Time 40 hours per week

Department of Veterans Affairs (FCCPAC) Orlando, FL September 2018 – April 2019

Essential role in the VA revenue cycle collecting and processing funds to support Veteran health care through processing all Veteran requests and notices.

Collected, analyzed and prepared data and public vouchers for processing.

Assisted other CPAC departments and VA facilities with inquiries, technical support and clerical requests as needed.

Processed refund review requests received by Veteran and other VA departments, pre-payments, claims matching, and rated eligibility.

Determined Insurance payments to be applied to Veteran's co-payment by reviewing account information.

Performed a review of First Party claims, link payments, processes write-offs, and suspends claims.

Provided patient centered customer service to Veterans who have complicated administrative problems or concerns about their accounts, while supporting the mission of the VA.

Assisted Veterans with applying for repayment plans and monitor payments for regular payment activity.

Helped Veteran complete application for waiver and bankruptcy, while suspending qualifying bills until a decision is made.

Verified outstanding balances on Veteran accounts and validates that referral to appropriate collection program is correct.

Processed adjustments on Veterans bills to reflect changes in the principal, interest and or admin charges due to change in eligibility status, priority group, income thresholds, and copay offsets.

Training utilizing black board Adobe Connect while accessing First Party Claims portal to process 30 claims per hour after month on employment.

Housekeeping Aide

Full-Time 40 hours per week

Department of Veterans Affairs Tampa, FL January 2018 – September 2018

Performed a full range of light, heavy and routine cleaning housekeeping duties. Duties include cleaning wards, patient rooms, storerooms, offices, corridors, restrooms, shower rooms, and other areas as follows: Scrubs, strips, waxes, and polishes floors using heavy powered scrubbers and buffers.

Washed walls using a powered wall washing machine.

Cleaned rugs using heavy vacuum cleaners.

Washes and replaces Venetian blinds and washes ceiling fixtures and room partitions using ladders and scaffolds.

Moved heavy furniture, supplies, and equipment and assisted with equipment installs.

Cleaned storerooms, offices, corridors, and stairways.

Cleaned and washes walls and windows inside only.

Removed soiled and contaminated linens from work area to soiled linen rooms, removes contaminated and uncontaminated trash, changes needle boxes, disposal of mercury spills, and treats areas infected with lice.

Kept restrooms in clean, orderly, and sanitary condition.

Ensured that cleaning supplies are in stock.

Noted condition of rooms and reports broken windows, water leaks, clogged drains, and other conditions requiring maintenance and/or repair work to the supervisor.

Removed stains from a variety of surfaces using chemicals and cleaning solutions.

Insurance Billing Specialist

Full-Time/ 40 hours per week

CRG (Health Plan Services) Tampa, FL October 2017 – January 2018

Processed and maintained internal computer systems enrollment and membership records related to the qualifications for coverage. Responded to internal and external inquiries regarding eligibility/enrollment and maintained membership records.

Core Responsibilities:

Processed enrollment and eligibility changes from members and/or internal reports

Produced rate quotations

Calculated premium adjustments

Responded to member requests via phone, mail, fax and email

Reviewed member applications for accuracy

Assisted call center as needed

Achieved all quality goals

Achieved all production goals

Checked figures, postings, and documents and ensured accuracy of entry.

Researched accounting records.

Resolved discrepancies between transaction documents and accounts as is appropriate.

Performed audits of selected payments for accuracy.

Temporary Eligibility Worker (Hurricane Irma)

Full-Time 40+ hours per week

CareerSource Tampa Bay Tampa, FL September 2017 – October 2017

Completed the eligibility portion of the application process by reviewing the Food for Florida application with the applicant and completing the budget worksheet portion of the application.

Interviewed applicants and evaluated the household's eligibility requirements.

Verified the identity of the applicant by viewing the Driver's License or Florida ID card.

Ensured application was complete, legible and properly filled out by completing the following steps:

Checked for complete and legible mailing address on application.

Ensured applicant was listed in part A, Household Member section.

Checked for First Name, Last Name and Date of Birth for each household member listed.

Verified applicant’s signature and date on application.

Ensured that authorized representatives applied on behalf of another completed Part C of application to include their full name and Signature.

Verified authorized representative’s Identification of person for whom they were applying.

Completed financial calculations from the budget worksheet portion of the paper application based on applicant’s estimations and signed.

Finalized denial notice for applicants who did not meet income eligible criteria.

Directed eligible applicants to provide their application to the EBT worker in order to receive EBT card and explanation of benefits.

If an alert is received, direct the applicant to the Customer Service Representative (troubleshooter) to resolve the issue.

Collected all applications (approved, denied, incomplete, blank) and placed approved and denial notices in the appropriate box for processing.

Escalated applicant issues to the Site Supervisor as needed.

Volunteer Nursery Childcare Worker

Full-Time/40+ hours per week

Revival Ministries International, Tampa, FL January 2015 to September 2017

Supervised and monitored the safety of up to twenty-five toddlers.

Assigned daily tasks and weekly shifts to workers and volunteers to ensure each shift was fully staffed.

Evaluated the work and activities of workers to ensure that all safety protocols were followed.

Resolved complex problems between children, staff and parents.

Handled personal conflicts between children and initiated discipline as necessary.

Prepared and taught daily and weekly lessons.

Organized, prepared and served meals and snacks as instructed by parents.

Coordinated activities and implemented curricula that stimulated the children's spiritual, physical, emotional, intellectual, and social growth.

Preplanned daily and long-term schedule of activities.

Fostered positive relations between RMI and the community through activities and functions that foster collaboration to assist low-income families and those in need.

Retail Sales Associate

Part-time/20-30 hours per week

Macy’s Brandon, FL November 2015 - February 2016

Greeted and connected with customers, asked questions, listened to needs, and suggested products to meet those needs.

Inspired customers to buy, celebrated the purchase, and created a lasting positive impression of myself, the Company, and the purchase.

Learned systems and procedures to enhance selling efficiencies and completed support duties.

Consistently exceeded daily personal sales and Star Reward goals.

Learned, developed and implemented product knowledge through customer interaction to promote products and services.

Researched and read current vendor tags and pamphlets in order to communicate product effectively to the customers.

Behavioral Health Intake Coordinator

Full-Time/ 40 hours per week

WellCare, Tampa, FL December 2013- July 2014

Received and answered calls in the call center according to established service standards.

Collected and verified patient and provider information to verify eligibility, provider status, benefit coverage to coordinate patient benefits.

Processed inpatient requests and approved standard outpatient authorization requests as determined by the health plan.

Applied policies and procedures, regulatory requirements and accreditation standards to all activities.

Performed data entry of authorizations into an electronic medical management system.

Placed outbound calls to coordinate needs.

Received and sent incoming and outgoing faxes.

Trained over 6 new employees, resulting in an increase of 90% output of authorizations.

Customer Service Support Representative

Full-Time/ 40 hours per week

LabCorp Tampa, FL June 2013- December 2013

Served as a liaison between LabCorp branches and its customers, in response to inquiries and problems.

Researched, troubleshoot and resolved customer problems. Performed data entry for courier service.

Appointment Clerk

Part-time/20-30 hours per week

General Dynamics Ft. Campbell, KY October 2012- June 2013

Scheduled patient appointments, according to department protocols and scheduling guidelines.

Registered new patients.

Confirmed and updated demographic and insurance information.

Triaged established patients according to defined nursing protocols.

Utilized medical terminology to generate messages to primary care.

Medical Support Assistant

Full-Time/ 40 hours per week

Department of Veterans Affairs Tampa, FL October 2009 – July 2012

Provided administrative support for the Centralized Scheduling Unit.

Entered, modified and retrieved, verified and updated patient demographic and insurance information to provide appointment management for follow-up primary care and specialty clinics.

Provided clerical work in the care and treatment of patients in outpatient clinics to include scheduling, canceling and rescheduling appointments.

Adjusted appointment times, locations, or dates due to conflict with staffing, coverage, or patient generated problems.

Addressed patient complaints and resolved problems.

Interpreted and communicated requirements of VHA Directive 2002-059 for Priority of Outpatient Medical Services and Inpatient Hospital Care.

Accomplishments

Supervisor letters of commendation for number of calls received and fast response answering calls.

Received national recognition as best scheduling unit among all VHA’s in the United States.

Medical Billing Check-Out Clerk

Full-Time/ 40 hours per week

Tampa Family Health Center Tampa, FL December 2008 – October 2009

In accordance with the Center’s policies and procedures accepted money from patients and properly imputed transactions into the database.

Reviewed and reconciled all EOBs on a timely basis to determine payment status to appropriate patients and dates of service.

Posted all remittances to patient accounts.

Prepared schedule for all required “specialist” services and ensured the proper payment and posting of service.

Prepared, filed and processed encounters with End of Day Reports and obtained appropriate signatures.

Assisted in the filing and mailing of insurance claims, when needed.

Balanced money daily and secured all cash according to company policies.

Data entry of CPT/ICD 9 codes to process patient payments and verify account status.

Performed other duties as assigned by supervisor such as: scheduling appointments, answering telephone, verifying patient demographics and pulling charts.

Accomplishments

Ensured accurate and timely processing of encounters for end of quarter reporting.

Customer Service Representative/Receptionist/Data Entry Clerk

Full-Time/ 40 hours per week

Temporary contracts with various organizations April 2000- September 2008

Temp Wise Inc.-Used Microsoft Excel to create new worksheets and files. Performed data entry of daily safety forms. Scanned safety documents using a copier and emailed to the safety director. Used Microsoft Outlook to access scanned documents and transferred to subcontractor files. Performed various secretarial works to include filing, preparing orientation exams and related training material.

Office Team - Processed patient referrals for hospitals and clients and forwarded to the correct department. Entered patient demographics, insurance information and diagnosis codes. Created new patient accounts when necessary. Used CPT/ICD9 coding book to obtain diagnoses. Identified payer sources and verified benefits.

Bartech Group - Data entry of property dimensions, locations and other related information. Manipulated data and proofread new entries for accuracy. Entered, updated, researched, verified, and retrieved data. Organized and prioritized time to perform multiple tasks.

x - Handled inbound calls in a call center. Resolved customer inquiries, billing issues and product concerns. Processed billing requests and credit adjustments. Provided limited technical support. Performed limited administrative duties to include faxing, filing, and copying, mailing correspondence and data entry. Inventoried supplies and placed orders as necessary.

Program Coordinator, Residential Housing for Women

Full-Time/ 40 hours per week

Christlike In-reach-Outreach Worship Center, Tampa, FL March 2006–September 2007

Coordinated services, classes, housing, medical and daily operations for women.

Managed flow of clients being accepted and discharged for the program.

Provided administrative support to include typing, copying, answering telephone and intake of new clients.

PBX Operator

Part-time 20 hours per week

Oak & Pine Manor Nursing Home Columbus, GA April 2001 – October 2001

Used a multi-line telephone system to receive and transfer calls to correct extensions.

Greeted and assisted residents, visitors and family members.

Provided paging services for callers requesting employees.

Monitored alarm system.

Food Service Specialist Administrative Assistant

Full-time/ 40 hours per week

United States Army April 1995 – May 2000

Performed secretarial work to include menu preparation, money management, data entry, bookkeeping, and filing.

Typed memos and reconciled cash sheets to ensure accuracy.

Reorganized work patterns to increase efficiency and effectiveness of workload.

Developed and implemented new procedures resulting in an increase of paying customers.

oActing supervisor in absence of manager.

EDUCATION

Bachelor of Art, 01/2015-Present

River Bible Institute

Tampa, FL

Major: Theology

Bachelor of Science, 05/2014 – 05/2015

DeVry University

Tampa, FL

Major: Technical Management, Human Resource Management

54 credits

Technical Diploma, 01/2005- 04/2006

Erwin Technical Center

Tampa, FL

Major: Medical Assisting

44.5 credits/1300 hours

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