Customer Service Representative
Resume:
Melissa A. Maloy
Alden, NY *4004
Polished, professional Customer Service Representative offering:
*17 years of experience in high volume call center for a top health insurer in NYS.
*Strategic-relationship building skills. Listens attentively, solves problems creatively and uses tact and diplomacy to find common ground and achieve win-win outcomes, repairs trust, manages high volume workload with a deadline driven environment and consistently meets performance benchmarks.
*Was lead go-to person for new representatives and challenging phone calls as one of the mentors for newly established employees.
*Provides leadership for the continuous quality improvement for all aspects of customer service and clerical responsibilities while always maintaining a positive attitude in a high call volume, high stress environment. I continually show a positive attitude and past experience proves I excel at achieving a high morale within the department that I work.
Independent Health Corporation
01/15/24 – 12/18/2024
Account Representative
Specializing in Provider benefit and high-level sales in insurance industry.
Handled high volume of provider inquiries, disputes, and appeals, and provider correspondence, Support Administrator, Support Adjustments department provider inquires, disputes and appeals. Check Tracers/Stop Payments and Additional Finance Related Inquiries, Handle weekly reports,
Synergy IT Solutions
02/17/20- 11/24-2023 – Job terminated due to pandemic economy
Account Representative – Assessment, Design & Consulting Engineering Services and Virtualization & Storage Desktop & Document Management Solutions > Network & System Integration, Unified Collaboration for Small & Medium Business, Procurement & Installation, Help Desk & Managed Services Remote Monitoring Solutions, Service Assurance & Maintenance
Delaware North – Temporary Position
02/17/20- 11/24-202009/2018 – 05/2019
Human Resources Customer Service Representative in the Associate Service Center at Delaware North, one of the largest privately-held hospitality companies in the world. A global leader in hospitality and food service with operations in the sports, travel hospitality, restaurants and catering, parks, resorts, gaming and specialty retail industries. Provide orientation for new employees by sharing onboarding packages and explaining company policies, Handle grievance & complaint issues. Assisted in high volume payroll processing center that handles over 60,000 employees. Process employees’ requests and provide relevant information. High volume of employment related email and phone calls regarding background checks, new hire paperwork and orientation. Performed day to day activities including posting job openings reviewing resumes and scheduling interviews. PC literacy and experience with MS Office applications.
Medical Answering Service (MAS) – Temporary Position
01/2018 - 08/2018
Customer Service Representative in high call volume call center - MAS handles over 5 million NYS Medicaid enrollees who are in need of transportation for medically necessary doctor appointments which were the most cost effective for the State of NY based on individual need and level of care. I worked with physicians, field liaisons, hospitals, facilities and Medicaid administration to approve the most cost effective mode of transportation through a prior approval process. We also specialized in commercial travel for critically ill patients who needed out of state or out of country travel based on medical necessity. I worked closely with upper management and the NYS Department of Health to meet our specific yearly budget.
Lawley Brokerage Group
08/2016 – 09/2017
Customer Service Representative - Assisted Employer groups with the following: Group Dental, Life Insurance, Accidental Death, Dismemberment Insurance, Vision Insurance, Long-term disability and Short-term disability insurance. Attended open enrollment fairs to educate employer groups on benefits and claims. Attended and assisted marketing representatives with open enrollment fairs and meetings with a book of business of over 50 Buffalo based employer groups.Maintained a high level of professionalism for a well renowned Buffalo NY brokerage company. Created reports and open enrollment binders for employer groups. Assisted with employer group meetings to discuss benefits and cost analysis reports for employer groups to educate them on all costs related to employer benefit coverage.
EXCELLUS BLUE CROSS BLUE SHIED / FLRX PHARMACY HELP DESK
06/1999 – 08/2016
Customer Service Support - Provided leadership support in high volume call center for inbound customer service inquiries at one of the top health insurers in NYS.
Handled high volume of escalated calls and supervisor calls while maintaining the integrity of the company standards and doing the best job I could do to advocate for our members and their concerns.
Provided positive support to customer service trainee’s and consistently improved department morale with a positive attitude even in high stress situations within our demanding department.
Was the lead go-to person for new representatives and supervisory situations within the department. Was the mentor and trainer for both new and established staff members.
I have strong strategic and relationship building skills. I always listen attentively and empathetically to staff members and our members calling into the call center. I use creative problem solving skills along with tact and diplomacy to find common ground and solving issues in a timely fashion for the customer and the corporation.
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