Call Center Customer Service
Resume:
Angel Loggans
Bonaire, GA *****
************@*****.***
Professional Summary
Customer service and healthcare support professional with over 10 years of experience in insurance, call center, and client support environments. Skilled in handling high-volume inquiries, resolving escalations, and ensuring compliance with Medicare, Medicaid, and company policies. Recognized for strong communication, problem-solving, and ability to thrive in fast-paced, remote environments.
Professional Experience
GEICO – July 2025 – Present
Service Representative
* Serve as the first point of contact for customers, addressing billing inquiries, policy changes, and coverage recommendations.
* Provide personalized service to strengthen customer relationships and drive satisfaction.
* Resolve issues via phone and email while maintaining clear communication with supervisors and team members.
* Utilize GEICO systems and tools to deliver accurate information, manage workflow, and support business goals in a high-volume call center environment.
VIVA USA INC (Contractor for BlueCross BlueShield TN) – July 2023 – July 2024
Clinical Assistant
* Screened and triaged UM/CM calls, faxes, and digital requests, directing cases to appropriate departments.
* Resolved inquiries and claims while meeting departmental goals and compliance standards.
* Entered organizational determinations and documented data in compliance with policy.
* Collaborated with providers, hospitals, and members, providing case status updates and requesting additional documentation when needed.
* Conducted Medicare appeals case reviews, meeting or exceeding mandated timelines.
* Trained new employees on resolution management processes and system navigation.
VIVA USA INC (Contractor for CVS Health) – Oct 2022 – Feb 2023
Medicare Authorizations & Appeals Inbound Analyst
* Handled high-volume inbound calls related to Medicare prior authorizations and appeals.
* Resolved escalated beneficiary and provider inquiries, ensuring compliance with CMS regulations.
* Reviewed and processed appeals using multiple software systems while exceeding productivity and quality standards.
* Educated prescribers and patients on authorization processes, timelines, and requirements.
Advanced Call Center Technologies (Bank of America Fraud Dept.) – Jun 2022 – Oct 2022
Fraud Analyst
* Assisted customers with fraud claims, merchant disputes, and compromised accounts.
* Conducted transaction research and advised customers on dispute resolution timelines.
* Removed fraud blocks, replaced cards, and handled escalated cases with professionalism.
CVS Health – Oct 2019 – Jun 2021
Medicare Authorizations & Appeals Analyst
* Managed Medicare Part D appeals and prior authorizations, ensuring adherence to CMS guidelines.
* Communicated determinations to providers, patients, and beneficiaries through professional correspondence.
* Consistently met turnaround time, quality, and productivity standards.
* Trained and mentored employees on appeals processes and compliance.
Manpower Group (Contractor for Hulu) – Jan 2019 – Mar 2019
Viewer Experience Agent
* Delivered customer support for billing and technical issues via phone and chat.
* Troubleshot streaming and account issues, providing timely solutions.
* Supported operations teams by beta testing new chat tools and assisting peers.
Agero – Nov 2017 – Oct 2018
Roadside Assistance Associate
* Assisted stranded motorists with dispatching vendors and providing pricing estimates.
* Ensured timely service delivery through effective vendor communication.
* Handled escalated customer cases with professionalism and empathy.
Advanced Call Center Technologies (Bank of America Claims) – Feb 2014 – May 2016
Claims Specialist
* Filed and researched customer disputes and fraudulent transactions.
* Guided customers through dispute processes while adhering to compliance standards.
* Managed escalations and maintained accuracy in fraud investigations.
Education
Northeast State Technical Community College – Jan 2010 – Aug 2012
Associate of Applied Science, Networking Systems
* Vice President’s List – Spring & Fall 2010
Sullivan North High School – Aug 1999 – May 2003
Certifications/Licenses
License# 3830718
GA Personal Lines Agent
Key Skills
* Customer Service & Call Center Operations
* Medicare/Medicaid Prior Authorizations & Appeals
* Fraud Investigation & Claims Management
* Remote Work & Virtual Collaboration
* Conflict Resolution & Escalation Handling
* Compliance with CMS and Healthcare Regulations
* Technical Troubleshooting & System Navigation
* Training & Mentorship
Contact this candidate