Customer Service Support Agent
Resume:
Jamie Diallo
Indianapolis, IN *****
*************@*****.***
Professional Summary
Skills and Accomplishments
• Excellent customer service skills that build high levels of customer satisfaction
• Fluent in English, Spanish and French
• Excellent verbal and written communication skills
• Ability to make confident decisions based on available information
• Strong analytical, computer, and time management skills
• Management and leadership experience
• Effective people skills and sensitivities when dealing with others
• Vast experience working remotely WFH
• Strong attention to details and dedication to achieve results
• Excellent work ethic and discipline
• Highly motivated, self-starter with ability to work independently and as a team to achieve goals and objectives
• Quick and avid learner with an inquisitive mind
• Outstanding presentation skills (technical and soft skills)
• Strong leadership skills
• Superb problem-solving skills
• Prioritize all projects with varying deadlines
• Thrive in a fast paced, start-up like environment Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Broker Support Agent
Health Plan One-Remote
June 2025 to present
• Assist with the contracting process for new Medicare brokers, including documentation, review, and certfication
• Help Medicare brokers access their online accounts and register for certfications
• Assist with password reset and website unlock, as well as website naviguation
• Address broker inquiries related to benefits, eligibility, applications, and other related matters
• Manage commission payments, including accurate calculation, timely disbursement, and reconciliation of records
• Partner with internal sales teams to support growth strategies, potentially including organizing events, coordinating training, and facilitating lead generation
• Maintain accurate and up-to-date broker records, including agent information, certification details, and commission payment records
• Demonstrate strong product knowledge to effectively answer brokers' questions and provide accurate information
• Ensure brokers adhere to relevant regulations and guidelines related to Medicare sales and enrollment
• Investigate and resolve broker complaints and issues, ensuring timely and appropriate resolution
• Develop and maintaining a strong understanding of Medicare plans and offerings to effectively support brokers
• Educate brokers on Medicare plan benefits
• Assist them in finding doctors and providers in their area
• Built rapport with brokers through active listening, empathy, and personalized interactions
• Maintain the security and privacy of Medicare members' personal health information
• Maintain detailed records of all customer interactions in CRM system for future reference and analysis
Bilingual Customer Service Representative
Concentrix-Remote
June 2024 to December 2024
• Help customers with their Medicare Advantage plans in English and Spanish
• Manage a high volume of incoming calls, consistently meeting or exceeding performance metrics for response time and resolution
• Demonstrate strong product knowledge to effectively answer customer questions and provide accurate information
• Educate members on their plan benefits
• Assist them in finding doctors and providers in their area
• Reviews members claims and bills
• Built rapport with customers through active listening, empathy, and personalized interactions
• Assist patients order medical supplies and home health services.• Maintain the security and privacy of patients' personal health information.
• Ensure the patient qualifies for the type and quantity of products ordered based upon the patient’s insurance and/or contract guidelines.
• Provide appropriate issue resolution and/or escalation when needed.
• Contact ordering physician's office to facilitate patient care
• Maintain detailed records of all customer interactions in CRM system for future reference and analysis
• Participate in regular training sessions to stay updated on product features, policies, procedures, and industry trends
• Recognized as a top performer within the department based on consistently high levels of customer satisfaction ratings
• Developed strong problem-solving skills through analyzing complex situations quickly while maintaining composure under pressure
• Provide exceptional customer service by promptly addressing inquiries, resolving issues, and ensuring customer satisfaction Tier 2 Medical Claim Analyst
Elevance Health-Indianapolis, IN
March 2023 to May 2024
• Manage a case load of approximately 130 claims per day
• Verify and determine applicability of coverage
• Conduct timely and thorough investigations per company procedures
• Review files on a timely diary for reserving adequacy and resolution plans
• Evaluate and adjust claims within authority level
• Application of policy and provider contract provisions to determine if a claim is payable. If additional information is needed, or if a claim should be denied.
• Determine the status of medical claims through research
• Reviewing charges, and use of payment or denial codes within established guidelines and standards
• Maintenance of records, files, and documentation
• Meet the standards of department production and quality standards
• Follow all policies and procedures established for the department.
• Analyze and process claims in accordance with plan provisions
• Maintain compliance with claim routing and inventory control procedures.
• Document, track and resolve all plan providers' claims projects.
• Adhere to all statutory and regulatory fair claims practices.
• Maintain the privacy, confidentiality and security of patients' personal health information
• Adhere strictly to all HIPAA and Government guidelines or regulations Customer Service Representative Biotel
Working Solutions-Remote
June 2022 to March 2023
• Manage incoming and out-going call activity related to customer service.
• Provide tech support to callers regarding their heart monitor
• Initiates the set-up of new Bio Tel Heart devices
• Provides user training as needed.
• Coordinate shipment of devices to patients' home
• Ensure every request is handled promptly.
• Process all email requests timely.
• Document all patient account contact in patient file.
• Handle requests for reports/medical records• Involve supervisory staff when necessary and makes recommendations for process improvement.
• Follow all policies, procedures and processes.
• Analyze problems and provides information/solutions.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develop and maintain positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Provide external and internal customers with requested information.
• Place follow-up telephone calls to answer customer questions that are routine in nature.
• Maintain the privacy, confidentiality and security of patients' personal health information
• Adhere strictly to all HIPAA and Government guidelines or regulations Facilitator, Learning Experience Guide
Omni Interactions
October 2021 to July 2022
• Provide education, resources, and tools to new hires on products, services, and processes to achieve their certification required to support client customers
• Support learners with their business partnership with Omni in a blended learning environment
• Identify students' knowledge gaps and quickly address their needs to ensure successful certification
• Responsible for attendance, performance, and certification tracking and reporting
• Escalate technical or performance related issues as appropriate
• Follow agendas and guides to lead agents to their certification success
• Responsible for delivering content as designed and to validate of readiness including hands-on activities, mock calls and other real-life knowledge checks to certify workers are ready to represent the client’s brands with excellence.
• Educate new hires on products, services, and processes to follow for the client
• Provide “in person” (virtual) facilitation for new and existing hires
• Work as an agent when not facilitating classes
• Isolate learning deficiencies and provide knowledge to bridge gaps
• Share information with Leadership Team as appropriate
• Use various quality monitoring tools to analyze data and track trends
• Deliver content for various courses
• Develop improvement programs focused on immediate and continuous improvement related to certification processes
• Complete department special projects as assigned by the Department Manager
• Perform any other task or assignment as deemed necessary by the organization.
• Schedule events and resources within the company Customer Service Representative
Omni Interactions
February 2021 to October 2021
• Provide customer support via phone and chat for various clients, ranging from the financial to healthcare sector
• Answer general questions or problems
• Handle customer inquiries and resolve basic support issues
• Receive inbound customer service calls
• Update customer information and ensure accurate entry of contact information
• Troubleshoot customer problems, identify and solve root cause of problems
• Update customer information and ensure accurate entry of contact information
• Troubleshoot customer problems, and identify root cause of problems
• Track and document inbound support requests
• Perform account maintenance
• Complete documentation and case information in a timely manner
• Maintain the privacy,confidentiality and security ofcustomers' personal information
• Adhere strictly to all HIPAA and Government guidelines or regulations Patient Care Scheduler
CareCentrix-Remote
November 2020 to February 2021
• Assist patients and representatives order medical supplies and home health services.
• Coordinate home health visits as requested by the ordering physician
• Maintain the security and privacy of patients' personal health information.
• Collect, interpret, verify, and accurately enter data from referral sources
• Complete paperwork to process patients' orders.
• Work closely with health plans/payers and maintain strong business relationships.
• Ensure the patient qualifies for the type and quantity of products ordered based upon the patient’s insurance and/or contract guidelines.
• Obtain insurance authorization when necessary.
• Provide appropriate issue resolution and/or escalation when needed.
• Advise of order status and delivery timeframes
• Contact ordering physician's office to facilitate patient care Front Desk Agent
Diallo Auto Repair-Indianapolis, IN
October 2019 to November 2020
• Greet customers entering the building, answering any questions, providing directions
• Alert staff when someone is there to meet or visit them
• Answer a multiple line phone system, manage calls by routing them to the proper extensions or taking messages
• Accept deliveries and mail, organize them to be distributed to the correct recipients using the office mailing system and ensure they get to the recipient in a timely manner
• Keep an inventory of materials and product in stock• Ordering auto parts and supplies when running low
• Manage outgoing mail and packages for pickup
• Serve as the face of the company, offering friendly service to those entering the building or calling in on the phone
• Assist customers to retrieve their vehicles once repairs are complete
• Maintain the reception area, keeping it clean and free of clutter
• Handle filing and data entry as requested
• Process payments
• Write invoices and credit memos
Bilingual Customer Service Representative
Total System-Columbus, GA
October 2016 to October 2019
• Provide financial customer service to cardholders both in English and Spanish.
• Perform maintenance on credit card accounts
• Safeguard the safety and privacy of customers' personal information.
• Resolve basic payment and account related requests such as balance inquiries...
• Do card activations, payments, name and address updates
• Notate and document all actions taken on cardholders' accounts.
• Enter required data into client provided systems and databases.
• Determine basic reasons for customer issues such as decline reasons, etc.
• Review account transaction with customers for any potential fraud
• Report and dispute fraudulent charges
• Refer compromised accounts to the Risk department for further investigation
• Replace damaged, lost or stolen cards in compliance with all security protocols
• Perform balance transfers
• Advise cardholders of account status
• Refer unresolved customer grievances and requests to Supervisor or designated departments for further investigation and resolution. Medical Receptionist
Pinnacle Family Medicine-Columbus, GA
January 2016 to September 2016
• Greet and welcome patients as soon as they arrive at the office
• Direct visitors to the appropriate Doctor
• Schedule patients' appointments
• Manage physicians' schedules
• Answer, screen and forward incoming phone calls
• Perform patients' intake and enter their information in the systems
• Ensure reception area is tidy and presentable, with all necessary stationery and material
• Provide basic and accurate information in-person and via phone / email
• Receive, sort and distribute daily mail / deliveries
• Provide clerical and secretarial support services
• Maintain office security by following safety procedures and controlling access via the reception desk (monitor logbook, issue visitor badges)
• Update calendars and schedule meetings
• Perform other clerical receptionist duties such as filing, photocopying, transcribing and faxing
• Process payments• Maintain the security and privacy of patients' personal health information in compliance with HIPAA
Secretary
Zion African Ministry-Phenix City, AL
June 2014 to December 2015
• answer calls, take messages and handle correspondence
• maintain diaries and arrange appointments
• type, prepare and collate reports
• file documents
• organize and service meetings (producing agendas and taking minutes)
• manage databases
• prioritize workloads
• implement new procedures and administrative systems
• act as liaison with relevant organisations and clients
• coordinate mail-shots and similar publicity tasks
• log and process bills or expenses
• communicate verbally and in writing to answer inquiries and provide information
• coordinate the flow of information with internal and external contacts
• operate office equipment
• manage office supplies
Administrative assistant
NLP Expert-Casablanca
October 2011 to November 2013
• prepare and manage correspondence, reports and documents
• organize and coordinate meetings, conferences, travel arrangements
• take,type and distribute minutes of meetings
• implement and maintain office systems
• maintain schedules and calendars
• arrange and confirm appointments
• organize internal and external events
• handle incoming emails, mail and other material
• set up and maintain document management systems
• set up work procedures
• collate information
• maintain databases
Education
GED
Columbus Technical College Adult Education - Columbus, GA January 2016 to April 2016
Skills
• Technical Support• Conflict management
• Transcription
• Data entry (10+ years)
• Presentation skills
• Medical records
• Microsoft Office
• Data Analysis
• Microsoft Powerpoint
• Clerical experience
• Leadership
• Software Troubleshooting
• Medicaid (1 year)
• Windows
• Training & development (Less than 1 year)
• Multilingual
• Translation
• Medicare (1 year)
• Communication skills
• ICD-10
• Medical Scheduling
• Technical support
• English
• Tutoring
• Google Docs
• Relationship management
• Live Chat
• Medical terminology
• Project management
• Documentation review
• Bilingual Spanish
• Tableau
• Microsoft Teams (1 year)
• Training & development
• Call Center
• Macess (1 year)
• Amazon Connect (1 year)
• Teaching
• Salesforce (1 year)
• CSR
• remote work (3 years)• Analysis skills
• Data analysis skills
• Customer Service
• Zendesk
• Medical Receptionist
• HIPAA
• Software troubleshooting
• Customer service
• Medical billing
• facets (1 year)
• Microsoft Excel
• Bilingual French
• Teaching (1 year)
• Salesforce
• Adult Education
• Slack (1 year)
• Learning technology
• Natural Language Processing
• Fluent Fulani
Languages
• Spanish - Fluent
• French - Fluent
Additional Information
• Computer skills: Microsoft Word, Excel, Access and PowerPoint, Salesforce, Facets, Macess, Webex, Zoom, Microsoft Teams, Slack
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