Customer Service Call Center

TENESHA SMITH, 313-***-****, ***********@*****.***

Professional Summary

Highly motivated and empathetic Customer Service & Claims Specialist with experience in the healthcare insurance industry. Proven track record of providing exceptional service, resolving complex claims issues, and ensuring customer satisfaction in high-volume call remote setting. Adept in navigating healthcare policies, HIPAA compliance, and system documentation. Seeking to contribute expertise to the customer-focused team at Cigna Health Care Group.

Core Competencies

Health Insurance Claims Processing

Call Center Support

Policy & Benefits Explanation

HIPAA Compliance

CRM & Claims Systems (e.g., Facets, Salesforce)

Conflict Resolution

Medical Terminology

Multitasking in Fast-Paced Environments

PROFESSIONAL EXPERIENCE:

Arrow Child & Family Ministries/ Burnett Specialists

8/2025-

Fill-in Receptionist

•Welcoming guests, clients and directing them appropriately.

•Managing multi-line phone systems, transferring calls, and taking messages.

•Maintaining a professional and organized reception area.

•Booking, confirming, and updating meetings or appointments.

•Providing information in person, by phone, or email.

•Receiving, sorting, and distributing incoming mail and packages; preparing outgoing mail.

•Data entry, filing, photocopying, scanning, and maintaining records.

•Monitoring and ordering supplies when needed.

HISD Transportation,

8/2023-5/2024

Dispatcher

•Planned and scheduled daily routes for a fleet of school bus drivers, ensuring efficient and timely transportation.

•Coordinated substitute drivers as needed to maintain full route coverage.

•Dispatched school buses and managed real-time route adjustments to address operational challenges.

•Addressed route and bus stop issues, resolving complaints through direct communication with parents and school principals.

•Handled behavioral and disciplinary concerns by liaising with relevant stakeholders to maintain safety and compliance.

•Performed various office duties, including managing inbound and outbound calls.

•Processed drivers’ timecards accurately to support payroll operations.

Percheron,

1/2023 – 7/2023

Administrative Assistant (Contract)

•Managed invoice entry for multiple projects, ensuring accurate processing and timely distribution of payments.

•Conducted B2B collections to support accounts receivable efforts and maintain cash flow.

•Provided project management support by coordinating communication with external companies and internal teams.

•Performed general administrative duties including filing, email distribution, and office organization.

•Utilized Microsoft Office Suite and NetSuite to streamline administrative and financial processes.

Group 1 Auto,

12/2022 – 1/2023

Customer Service Accountant (Contract)

•Collaborated directly with customers to resolve billing and account disputes, ensuring accurate adjustments and customer satisfaction.

•Prorated accounts, issued credits, and processed service requests in accordance with company policies.

•Managed account and contract cancellations, coordinating with relevant departments to complete necessary actions.

•Requested and tracked issuance of checks to vendors and clients as required.

•Reconciled general ledger accounts by comparing them with sub-ledger accounts to ensure financial accuracy.

A.C. Transport LLC,

3/2019 – 10/2022

Operations Manager

•Ensured monthly goals were achieved by overseeing driver hiring and reviewing shipping orders for accuracy and efficiency.

•Maintained strong relationships with vendors and clients, supporting effective B2B collections processes.

•Updated and maintained databases with insurance information, mileage logs, and billing records.

•Managed daily inbound and outbound calls to coordinate logistics and address operational issues.

•Collected outstanding debts from brokers and partner companies to support cash flow.

•Utilized Microsoft Excel (including Pivot Tables), Word, and SAP daily to streamline data management and reporting.

RGS-Bswift (Randstad)

12/2019-04/2020

TX- Seasonal Benefit Specialist

Enrolled employees in company’s annual Benefit’s programs.

Call Center Support

Policy & Benefits Explanation

Process inbound inquiries from members and providers regarding benefits, claims status, and eligibility.

Resolved 50+ daily customer calls with an average satisfaction rating of 95%.

Investigated and resolved complex claims issues, including coordination of benefits and provider disputes.

Documented all interactions accurately within internal CRM system in compliance with HIPAA standards

TDECU,

12/2017 – 02/2019

Loan Resolution Counselor - Collections (Contract)

•Initiated outbound calls and received inbound inquiries related to mortgages, credit card payments, and delinquent loans, including personal and business loans.

•Educated and counseled members on loan repayment options and strategies to bring accounts current.

•Utilized multiple systems and tools such as VLOOKUP, Microsoft Excel (Pivot Tables), Word, and NetSuite to manage account information and reporting.

•Multitasking in Fast-Paced Environments

•Conflict Resolution

BELFOR Property (Accountemps)

09/2017- 11/2017

Auditor

•Processed Crew Sheets Daily

•Verified Work Time

•Calculated Hours and submitted to payroll

•Entered information from receipts

•Compute totals using adding machines or calculator

•Data Entry

•Scanned/Copy Documents daily

•Multitasking in Fast-Paced Environments

Praying Angels Daycare,

05/2012 -06/2016

Virtual Administrative Assistant

•Made outbound calls to applicants regarding enrollment status and requirements.

•Entered accurate data into the system for application processing and record keeping.

•Managed accounts for parents receiving public assistance, ensuring timely payment and documentation compliance.

•Handled inbound calls, addressing inquiries and providing support to applicants and parents.

•Utilized multiple systems including NetSuite, Microsoft Excel (Pivot Tables), and Word to streamline administrative tasks.

Flagstar Bank (call center),

03/2008 – 03/2012

Loan Counselor (Collections)

•Counseled mortgagors ranging from low to high risk on alternative solutions to prevent property foreclosure.

•Analyzed and updated customers’ financial and income information to determine suitable repayment plans.

•Developed and implemented repayment strategies to collect past-due debts and bring accounts current.

•Worked closely with customers to resolve delinquency and restore account standing.

SKILLS

•General ledger reconciliation

•Words

•Spreadsheets

•Data Entry

•Microsoft Excel (VLOOKUP/Pivot Tables)

•SAP

•NetSuite

•Communication Skills

•Attention to detail

•Adaptability

•Time management skills

•Work ethic

•Interpersonal Skills

•Teamwork skills

•Claims Adjudication Software

•ICD-10/CPT Coding Basics

EDUCATION

Houston Community College, Present

Health Medical Science Katy, Texas associate’s degree

Cooley High School Detroit, Michigan,

General Studies Diploma

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