Operations and Customer Service Professional

Renee Roth

Perrysburg, OH ***** +1-419-***-**** ***********@*****.***

Professional Summary

Highly motivated individual seeking to obtain a position where I can utilize my knowledge and skill set with the potential for growth and advancement. Proficient in Microsoft Office Word, Excel, Outlook and AmDocs software suite. Highly organized with strong data entry skills, excellent communicator (written and verbal). Ability to work with Contractor Network (VASC) for scheduling and obtaining information. Work Experience

Team Leader

Pilot Flying J Perrysburg, OH

May 2023 to Present

Scheduling

Store operations

Inventory

Cash handling

Stock

Humana Customer Service Representative

Specialty Pharmacy

September 2022 to Present

• Handle customer inquiries via email and chat, giving prompt answers to customer questions.

• Provide knowledgeable help to customers and go the extra mile in providing the correct details to customer queries.

• Adhere to Service Level Agreement (SLA) deadlines in resolving customer complaints quickly and effectively.

• Collaborate with internal stakeholders such as the product and payments team for faster resolutions.

• Identify and escalate customer requests to managers when there’s a complex issue.

• Investigate complaints thoroughly and document findings

• Discuss outcome of investigation with the complainant by telephone

• Where required, write to the complainant to explain your findings, using agreed templates and Client company style guide

• Handled customer service operations remote work.

• Resolutions for Member issues

• Scheduling deliveries and shipments

• Resolved issues with billing and shipping of Specialty Pharmacy

• Research accounts and solve issues with communication and records

• Informed patients on information both beneficial and helpful in the billing of services. Member Services

Costco

September 2022 to October 2022

• Handled customer service operations remote work.

• Resolutions for Member issues

• Answering phone calls and written questions, concerns, and complaints regarding membership.

• Providing information on membership fees, policies, processes, benefits, products, and services.

• Actively listening to members and identifying their needs.

• Recommending and cross-selling products and services to members and potential members.

• Investigating and resolving or escalating membership and payment issues.

• Assessing member eligibility and processing payments, applications, and requests.

• Documenting all inquiries and maintaining accurate membership records. Freight Center Logistics

January 2020 to October 2020

• Loading, unloading, and moving freight between delivery and storage areas as instructed.

• Coordinating the movement of freight with other workers via radio communication.

• Scanning or documenting freight, as well as marking items with identifying information.

• Moving freight manually or with specialized machinery, such as forklifts, reach trucks, and pallet jacks.

• Stacking freight at specified locations using boards or pallets.

• Preventing damage to transported freight by using protective devices such as padding and straps.

• Adhering to weight restrictions, as well as stabilizing and guiding lifted freight with slings and hooks. Associate Manager

Family Dollar Corporation New Port Richey, FL

April 2017 to October 2019

• Provide customer service to customers in a courteous manner by assisting them with their needs

• Answer questions, provide information, and help customers find products they are looking for

• Assist store managers in maintaining inventory levels and ensuring that shelves are stocked with merchandise

• Keep track of sales and ensure that cash registers ring up accurate numbers

• Set employee schedules and monitor performance of employees

• Conduct audits and inspections of stores to ensure compliance with company policies and procedures

• Hire and train new employees

• Delegate work as needed

• Maintain records of transactions and other financial matters

• Prepare reports and make recommendations regarding operations Claims Specialist

United Healthcare Group Oldsmar, FL

March 2014 to June 2016

• Resolution of issues and date.

• Determines covered insurance losses by studying provisions of a policy or certificate.

• Establishes proof of loss by studying documentation and assembling additional information from outside sources.

• Documents specific claims by completing and recording forms, reports, logs, and records.

• Analyzes insurance claims to prevent fraud.

• Prepares reports by collecting, analyzing, and summarizing information.

• Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement.

• Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.

• Maintains quality customer service by following customer services practices and responding to customer inquiries.

• Provides legal support by assembling documentation for settlement action.

• Protects operations by keeping claims information confidential.

• Maintains a good relationship with insurance departments Special Projects Admin

Verifone Inc. Clearwater, FL

August 2014 to August 2015

• Installations Accounts maintained with email/fax communication.

• Built relationships with Contractor teams and drove alignment around contract commitments technical proficiency with PC related hardware/software (Point of

• Sale, PC, Windows, MS Office Suite).

• Familiar with MS Access, Petro C-Store industry related experience. Sales Associate Lead

Hess Express Palm Harbor, FL

March 2012 to January 2014

· Handled closing the store at the end of work hours.

· Was in a management position.

· Oversaw general Store maintenance.

CSR Specialist

GVX Melbourne, FL

December 2008 to March 2012

· Subcontracted position over several years.

· Oversaw handling the issues of customers.

· Increased sales of cable and television equipment and services.

· Troubleshooted equipment issues.

Department Manager

Pat Catan's Hermitage, PA

May 2000 to December 2008

· Department Head of Lighting, Seasonal and Craft Coordinating Projects.

· Customer Service Operations.

· Order entry and data management.

· Class instruction and presentations.

· Cashier Office Operations.

· Display and Event Coordinator.

Education

Human Services (Associates)

University of Phoenix

September 2016

Upper secondary education

Skills

Spanish Healthcare compliance Microsoft Office Customer inquiry handling Computer networking Computer operation Freight Customer service Microsoft Access Order entry Presentation skills Time management Clerical experience Nursing Contracts Blueprint reading Bilingual Event planning POS Project management HIPAA Medical administrative support Call center agent experience EMR systems Written communication Medicare Insurance verification Electronic health records (EHR) management Pharmacy software Data entry Logistics Phone communication Healthcare privacy protection Typing Phone etiquette Microsoft Outlook Medical office experience Dental office experience Appointment scheduling Customer support DME Maintenance ICD-10 Clinical trials Medical billing Research Technical sales Microsoft Excel Insurance sales Organizational skills Search engines Sales support English Client interaction via phone calls Office management Microsoft Word Communication skills CPT coding HCPCS Computer skills Sales Medical records Medical terminology Documentation review Slack Database management Call center Cashiering CRM software Motivational interviewing Windows

Languages

English - Fluent

Certifications and Licenses

ICD-10 Certification

March 2025 to Present

Presently half way through my certification through DeVry university

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