Remote Customer Service & Pharmacy Support Specialist

Susan Wolaver

Bakersfield, CA ***** +1-661-***-**** **************@*****.***

Professional Summary

A well balanced Customer Service Representative with experience in putting accurate information into the system in a timely manner. Answering high Inbound calls setting appointments. Transferring calls. Problem solving making sure the Customer feels valued. Comes with a Sales and health field background, Processing claims as well as Dental and Pharmacy needs. Work Experience

Top tier G5 Customer Service Representative

Delta Dental San Diego, CA

Pharmacy Customer Service Representative

Amerit Consulting Inc. Bakersfield, CA

January 2025 to May 2025

• Provided exceptional customer service by helping customers with their Pharmacy and insurance issues

• Also ensuring customer satisfaction.

• Managed a high volume of incoming calls and emails in a timley manner

• Built rapport with customers through active listening, empathy, and personalized interactions.

• Resolved complex customer complaints by investigating the root cause of the issue and implementing appropriate solution.

• Assisted customers in navigating within the company website,

• knowing how to manuver through the knowledge base and the different softwares

• Checking Authoriazations granting overrides, checking insurance to see if medications were going to be paid for

• Participated in regular training sessions to stay updated on HIPPA, Pharmacy policies, procedures.

• Handled billing inquiries, adjustments, and account updates accurately and efficiently inputting members information correctly into our system.

• Being a patient advocate helping and resolving.

• eligibility checks, benefits verification, and prior authorizations Dental Customer Service Representative (Remote)

Dialog Direct a Qualfon Company Remote

March 2023 to April 2024

top tier G5 representative at Delta Dental.

Answering high call volume, making outbound calls, live chat, email support, Communicate eligibility, benefits, claims processing, policies and procedures

Kept updated on HIPPA regulation

Document each customer encounter and resolution in appropriate computer tracking system Expediently access reference materials to analyze and determine appropriate responses to telephone, electronic, and written inquires. Schedule appointment.

Provided efficient and courteous service to customers at all times Skilled in using various software applications and programs including Microsoft Office and Adobe Creative, MMIS, Macess, among other systems used,

Meeting all timelines, eligibility checks, benefits verification, and prior authorizations Unemployment Department Claims Agent

Aston Carter contract position for EDD Bakersfield, CA March 2022 to April 2023

Analyzing claim information to identify discrepancies or missing information, claims processing. Assessing the information against requirements based on UI Code, Policies, and Procedures Sending employers standard forms to obtain additional information or clear up a discrepancy identify when a claim needs to be escalated Reviewing and resolving complex issues

Reviewing wage and income information, benefits payments, and cross-matching to determine if payments were made appropriately Notating all actions taken on a claim clearly and thoroughly All other duties as assigned by management to support claim processing. Independent Contractor Position

In Home Care Provider Bakersfield, CA

March 2019 to February 2022

Assisted with patients daily needs, giving medications at the appropriate time making meals, range of motion documenting all daily needs as well as taking and documenting vitals.

Medical Records/ Scheduler

Sierra Vista Clinic Bakersfield, CA

January 2015 to March 2019

Utilized computerized appointment scheduling system and supported updates Answered phones, returning messages

Created, maintained and entered information into databases Scheduled and confirmed appointments for members

Maintained accurate records of all scheduled appointments. Fundraising Specialist

MDS Bakersfield, CA

January 2014 to January 2015

I worked in a call center cold calling the republican party getting donations. High calls keeping accurate information into the system Telemarketer

Olans Mills Portrait studio Bakersfield, CA

February 1999 to January 2014

Selling Portrait packages to customers cold calling I also became an appointment setter for Olan Mills Customer Service/Travel Agent

Wonderers Travels Arcadia, CA

June 1984 to February 1987

Helping with flights reservations Car Rentals Documenting information. Confirming reservations helping find the best rates out there making sure our customers are happy with their travels Education

Temple City Retirement Home Temple City, CA

January 1987 to December 1987

GED

Azusa Adult School Azusa, CA

January 1984 to January 1984

Skills

Jewelry sales Working multiple systems (10+ years) HIPAA Adobe Creative Suite Paying attention to detail HTML Microsoft Outlook Customer issue escalation Databases Outbound sales Medical records Customer support experience within hospitality industry Medical and Dental Terminology Customer service Order processing Analyzing claims UI Attention to detail Problem solving Data manipulation Appointment scheduling Productivity software Dental terminology Written communication Data entry Computer operation Writing skills Outbound calling Phone call management Live chat Home health CRM system proficiency Analysis skills Microsoft Word Salesforce Cloud Health Insurance Claims processing Communication skills Understanding Customer Needs Teamwork and Collaboration Client services Microsoft Excel Customer support Telemarketing Windows Problem-solving Antivirus software Creative problem-solving Sales Technical Proficiency Tech Proficiency Multitasking Experience in non-profits

Languages

English

Certifications and Licenses

CNA

First Aid Certification

CPR Certification

Driver's License

Additional Information

I would like too fill in the gap from March 2025 till now. I needed surgery and was able to take care of it during that time. Im great now and am anxious about getting back to work.

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