Customer Service Rep
Resume:
Roy T. Boyd
Monona, WI *****
Mobile:608-***-****
Email: **********@*****.***
Professional Experience
Auxiant
Customer Service Representative
Be a point of reference for providers, members as well as many other inquiries regarding claim status, prior authorization along with quoting benefits for a number of self funded insurance plans
Oct. 2022 - Apr. 2025
Neugen Health
Senior Member Health Ops Rep
Feb. 2020 to Sept. 2021
Responsible for preauthorization requests created in order to foward to clinical staff. Responding to internal customers as required.
Member Services Rep
Primary source for members in regards most healthcare inquiries about their health insurance.
Oct. 2018 - Feb. 2020
Wisconsin Physician Services
Care Management Intake - Employee Health- March 2014 to Current
Primary point of contact WPS employees and providers for prior authorization benefit related inquiries.
Wisconsin Physician Services
Customer Service Rep.-Medicare Part B. Feb 2008 to Mar 2014
Assist providers and auxiliary staff resolve claim related inquiries, as well as clarify and interpret policies as it applies to Medicare Part B. Provide technical support to various users of the CMS Secure Net Access Portal (CSNAP) in various capacities such as the navigation, training, resetting of passwords, as well as being a monitor for the appropriate use for the provider resource. As a result of my involvement with CSNAP, the extensive knowledge obtained, resulted in an opportunity to fill a role as a Tier -2 Rep to assist with escalated more complex inquiries.
CUNA Mutual Group
Customer Service Rep- AD&D / Directory Assistance- March 2005 to July 2007
Assist financial institutions, primarily credit unions, with multiple tasks involving the eligibility, processing, and disposition criteria pertaining to multiple insurance products such as Credit Disability, Credit Life, Accidental Death and Dismemberment, along with Debt Cancellation Unemployment Insurance. Other financial based products are offered to its national customer base with the objective to provide member with professional, courteous customer service. Along with those responsibilities, the department was awarded the assignment of corporate directory assistance.
United Government Services (UGS)
Lead Claims Associate – September 2002 to December 2004
Provided assistance to providers and their staff with solutions to inquiries related to certification and recertification as it related to the Wisconsin Medicaid Program. Conduct weekly quality assurance audits on the department to ensure mandated quality and deliverable standards were met.
Health Insurance Risk Sharing Plan (HIRSP) – April 1999 to August 2002
Customer Service Rep / LAN Support
Assist providers and their representatives, policyholders, insurance agents, etc. with high quality customer service interpreting the HIRSP insurance plan and its policies. Additionally was involved in the implementation of software updates and technical support for the department.
United Government Services (UGS)
Customer Service Rep- March 1997 to April 1999
Provide support to medical providers and their staff resolving claims and certification related inquiries as it pertained to the Wisconsin Medicaid Program.
Diny & Associates – December 1992 to March 1997
Tele-Sales Supervisor
Conducted the hiring and training of customer staff, along with monitoring company mandated performance standards.
Education:
UW –Rock County
September 1984 to January 1986 - General Studies
Janesville, WI 53545
Beloit Memorial High School
Beloit, WI 53511
September 1981 to June 1984 -College Prep Studies
Additional Skills:
Medical Terminology Training
Microsoft Excel Certificate
Microsoft Sharepoint Certificate
Employee Committee Board Member
Honors Awards:
National Federation of State High School Associations, June 2006
The purpose the NFHS members is to enhance the educational experience of high school students and reduce the risks involved in the participation interscholastic activities. NHFS members promote participation and sportsmanship to develop good citizenship through sports.
Subject Matter Expert, January 2002
Performed various training throughout the department for the purpose of improving the staff’s quality assurance standards. The program was based on a nationally known program (ISO 9000), as monthly training sessions were conducted to elevate each SME’s ability to relate the information to the staff. Along with quality assurance standards, each employee was responsible for confidential information, and had to be well versed in state confidentiality standards.
References :
Available upon request
Contact this candidate