Customer Service & Care Coordination Specialist
Resume:
WORK EXPERIENCE
Insight Global, Remote **** – present
CUSTOMER SERVICE AGENT
Managed a high volume of customer interactions in a state-of-the-art service center serving 2.4 million customers, addressing service orders, emergency outages, and billing inquiries.
Facilitated seamless electric service transfers and disconnections for a large customer base.
Educated customers on Georgia Power efficiency programs, contributing to customer understanding and resource management.
Successfully handled collections, navigating sensitive financial conversations while maintaining positive customer relations.
Provided comprehensive information on products and services, ensuring customer satisfaction and clear communication.
Collaborated effectively with internal teams to resolve complex customer issues and streamline service delivery.
Resolved customer inquiries regarding service orders, emergency outages, and billing, ensuring accurate and timely solutions.
Pearl Interactive Network, Remote 2020 – 2024
SCHEDULER
Adeptly gather and analyze data based on patient diagnoses and chief complaints to ensure accurate care planning.
Interpret ICD-10 codes and referrals to precisely determine the appropriate level of care.
Effectively coordinate with diverse stakeholders, including multiple facilities, VA personnel, and clinical staff.
Serve as a crucial liaison between veterans and the VA, ensuring clear communication and support.
Consistently achieve weekly quality and production goals, while also contributing to additional veteran support projects.
Logisticare, Atlanta, GA 2015-2020
FACILITY REPRESENTATIVE
Coordinate non-emergency transportation for Medicaid recipients with medical facilities and transportation providers.
Verify insurance eligibility for Medicaid, Medicare and HMO recipients. Assist in instructing medical facility employees on how to complete various required reports and documents.
Interact with facility social services staff to organize patient trips.
Analyze and audit provider transportation records.
Validate trip confirmations received from facilities.
Provide outreach to medical facilities.
Process and escalate facility complaints to State Medicaid.
Identify potential fraud and abuse.
Provides written response to complaints/fraud and abuse.
Process and review approved patient restriction forms.
Logisticare, Atlanta, GA 2004-2008
CALL CENTER SUPERVISOR
Supervise call center with over 30 employees, responsible for coordinating non-emergency transportation for Medicaid and HMO recipients in 13 states.
Provided training in customer service while actively encouraging employee development and advancement.
Performed comprehensive call quality reviews and introduced incentive programs to improve department productivity.
Prepare reports documenting abandonment rate and production to Senior Management.
Consistently exceeded monthly performance metrics.
Assisted in revision of company call quality program to maintain consistent rating and performance.
Department of Family and Children Services, GA 1996-2004
CASE MANAGER
Determine eligibility for TANF, Food Stamp, Medicaid, and Childcare recipients.
Process applications and reviews using appropriate criteria and policy consistently, according to established state guidelines.
Record and evaluate personal and financial data obtained from recipients.
Refer recipients to additional community resources.
Maintain thorough caseloads and wrote detailed reports.
Served as lead worker and trainer.
EDUCATION
Master of Arts: Health Services Administration, Strayer University, Atlanta, Georgia, 2015
Bachelor of Arts: Sociology, Valdosta State University, Valdosta, Georgia, 1994
PROFESSIONAL SKILLS
Performance Management Skills
Customer Service Skills
Call Center Management
Process Improvement
Project Management
Microsoft Suite Proficient
Leadership/Results-oriented
Staff Training and Development Skills
Process Development
Deliver clear/effective messages
Performance Optimization
Leadership Skills
Remote work Experience
Analyze and interpret medical records
Problem Solving
Meets Deadlines
Listening/Critical Thinking
Attention to Detail
Written Communication
Extensive knowledge of medical policies
Conflict Resolution Skills
Contact this candidate