Customer Service Professional with Benefits Expertise

Kym Walker

Buckeye, AZ ***** +1-480-***-**** ***********@*****.***

Work Experience

Custom Care Representative

Wiverse Boulder City, NV

March 2025 to Present

Calling and emailing clients to give them the updates on their orders. Working from a set list that are priority and work to contact and update the client as to the status of the order. Utilize internal systems to track and notate their work and who they have updated

Customer Service Representative

Alight Solutions Lincolnshire, IL

June 2023 to February 2025

• Handling a high volume of inbound calls from our client’s employees to answer questions, provide education, and solve complex HR and financial issues related to their health care benefits, Medicare benefits, 401k savings, retirement plans, leaves of absence, payroll, etc.

• Making outbound calls to follow up on tickets or confirm/reschedule a participant's appointments.

• Processing transactions such as health enrollments, tax and direct deposit updates, 401k withdrawals or contributions, and retirement elections. This may include additional research and ongoing casework.

• Leveraging your computer navigation skills to toggle between multiple screens and systems to provide answers and support. This may include assisting the caller in navigating the system as well.

• Creating and updating files in our database and communicating with third parties to research and assist the customer with updates or inquiries.

• Accurately documenting all conversations and actions taken on each interaction. Required Experience:

Customer Service Representative

Media Riders Remote

September 2022 to September 2023

Assist members with the benefits information, explain procedures and eligibility. Assist providers with eligibility, procedure codes, explanation of benefits on dental plans. Assisted with appeals, and claims. Customer Service Representative I

Reed Group Management LLC Colorado Springs, CO

May 2021 to October 2022

Helping people nationwide navigate through the logistics and concerns of managing leaves of absence from work; Answering incoming calls in a service center from employees who need help opening, extending, closing leave of absence, providing assistance on all documentation needed on all leave types, Contacting leave manager via teams chat. work with 360 absence solutions platform, Leave pro platform, and Confluence. Follow call flow requirements and meet metrics.

Member Service Representative

Blue Cross Blue Shield of Arizona Advantage

January 2020 to March 2021

Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication.

• Answer a diverse and high volume of health insurance related customer calls and correspondence on a daily basis.

• Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.

• Explain to customers a variety of information concerning the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBS programs, provider networks, etc.

• Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.

• Document and record facts in regard to inquiries and correspondence by updating BCBS files and system.

• Demonstrate and maintain current working knowledge of the required BCBS systems, procedures, forms and manuals.

• Review of healthcare service requests for completeness of information

• Collection and/or transfer of non-clinical data

• Review of healthcare service requests for completeness of information

• Collection and/or transfer of non-clinical data

• Utilization Management-related accountabilities for Provider Assistance staff include:

• Review of healthcare service requests for completeness of information

• Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.

• Answer a diverse and high volume of health insurance related customer calls and correspondence on a daily basis.

• Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.

• Explain to customers a variety of information concerning the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBS programs, provider networks, etc.

• Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.

• Document and record facts in regard to inquiries and correspondence by updating BCBS files and system.

• Demonstrate and maintain current working knowledge of the required BCBS systems, procedures, forms and manuals.

• Utilization Management-related accountabilities for FEP staff include:

• Review of healthcare service requests for completeness of information

• Collection and/or transfer of non-clinical data

• Utilization Management-related accountabilities for Provider Assistance staff

• Review of healthcare service requests for completeness of information

• Collection and/or transfer of non-clinical data

• Collection of defined clinical data using structured scripts or tools

• Activities that do not require interpretation of clinical information or decisions regarding utilization of any clinical criteria for handling of a request for healthcare services or treatment. Customer Service Representative II

Advisor Group

Microsoft Phoenix, AZ

January 2019 to September 2019

• Create a strong working relationship with Advisors and their assistants.

• Educates advisors where to find online information.

• Process incoming online requests from Advisors and resolve requests in a timely manner.

• Log transactions into CRM system for most inbound calls

• Work with peers and management to resolve issues.

• Pay close attention to detail, process work accurately.

• Exercising the appropriate judgment when escalated issues may require a supervisor or manager.

• Ability to communicate with other business units within the Advisor Group to resolve advisors concerns and issues.

• Analyze problems and follow through to resolution.

• Meet quality and production goals.

• Strong interaction with clearing firm and external vendors on routine brokerage account platform questions.

• Assist with other projects as needed.

• Provide peer to peer training.

• Keeping up to date on changes to industry and business processes. Proficient at Microsoft Word, Excel, Salesforce, Internet Explorer, Outlook, PowerPoint. NetX360, Streetscape and WMP platform Senior Contact Representative

University Of Phoenix Phoenix, AZ

February 2013 to September 2018

Respond to and answer general and routine customer inquiries, which may include, relaying information about University policies and procedures and/or student inquiries regarding academic records. Receives and responds to all transcript requests, letter requests, requests for verification and other academic related requests in a timely and efficient manner and following established guidelines and procedures. Resolves routine customer service issues, encouraging callers to provide further information when necessary and resolving escalated issues. Answers and responds to customer inquiries regarding special campaigns, as well as distributes student information to the appropriate official. Receiving and delivering messages or transfer calls to voicemail when appropriate personnel are unavailable. Redirects student callers to the appropriate resource as well as, resolving issues while exercising tact and diplomacy. May log and track incoming and outgoing telephone calls, as well as, report call volume data and trends to management following established departmental guidelines and procedures. Maintains a current programmatic and technical knowledge by attending training, educational workshops or professional development classes. May attend other skills based training and performs other duties as assigned or apparent. Collection Agent II

Credit Resolution For Mortgage, Retail And Recovery Collections Phoenix, AZ May 2009 to January 2011

Matrix Mortgage Company Phoenix, AZ

Managed accounting operations, accounting close, account reporting and reconciliations. Executed accounts receivable reporting enhancements and reconciliation procedures. Performed debit, credit transactions on computer spreadsheets/ databases by using specialized accounting software. Received, recorded, and banked cash, checks, and vouchers as well as reconciled records of bank transactions.

Assisted senior-level credit officers with complex loan applications. Adhered to all federal and state compliance guidelines relative to retail mortgage lending.

Education

Finance (2 college)

GateWay Community College Phoenix, AZ

1991

Skills

Filing Clerical experience Organizational skills EMR systems Sales Medical billing Databases Confluence Asimut Wed Dialer Application Office (7 years) Window 7 Medical office experience Customer Support Negotiation Data entry Communication skills Attention to detail Is3 Finance Intake Conducting sales calls Time management Galaxy Microsoft Insurance verification Genesys Microsoft Excel QTask Client interaction via phone calls Care plans Mozilla FireFox Call Center Patient admission assessments Salesforce Skype Customer support CRM system proficiency Customer Care Customer service HIPAA Medical records Certifications and Licenses

Driver's License

Contact this candidate