Second Shift Contact Center Professional Resume Title

Monica Brumfield

(Birmingham, AL)

Summary:

I am an experienced professional with 5 years of experience working as “Customer Service Agent”, “Patient Service Representative” etc. with “Cigna/Concentrix” etc.

● I have extensive experience in customer service, handling 100+ Outbound and 150 +Inbound calls from patients, physician offices and members to gather information, referrals/authorizations, and schedule appointments, following HIPAA and Compliance confidentiality and guidelines.

● Assisted providers with authorizations, claims, appeals, eligibility, and benefits eligibility and maintain member and provider satisfaction with forward-thinking strategies focused on addressing member/provider needs and resolving concerns.

● Research and analyze eligibility, other health information, and group data for issue identification and root cause, developed and tested interim solutions, managed eligibility implementations, and monitored results.

● Proficient in Microsoft Word, Microsoft Excel, Outlook, PowerPoint, Medical Insurance, eligibility, Data Entry, Customer Service etc.

● I have been responsible for contacting insurance companies and government benefit authorities to verify patient coverage within the first 24 hours.

Education:

Ultimate Medical Academy - Clearwater - Clearwater, FL Associate of Science: Medical Billing and Coding

Ultimate Medical Academy - Clearwater - Clearwater, FL Associate of Science: HIPAA Essentials For Healthcare Professionals Cert FCI Education Department - Tallahassee, FL

High School Diploma

Skills:

● Microsoft Word

● Microsoft Excel

● PowerPoint

● Eligibility

● Benefits

● Customer Service

● Patient Service

● HIPPA

● Time Management

Professional Experience:

Cigna Healthcare (Temp Service) Hoover, AL Aug 2023 - Jun 2025 Customer Service Representative

● Interacted with agents and providers via inbound calls.

● Assisted with Medicaid and Medicare eligibitity verification.

● Provided benefit information regarding Medicare plans available.

● Verifying a Providers participation status. In/Out Network.

● Managing multiple networks to confirm NPNs, locations and hours of operation.

● Always maintained a positive attitude when assisting the agents.

● Assisted with sending out enrollment information. Concentrix (Direct Client) Birmingham, AL Aug 2021 - Apr 2023 Customer Service Agent

● Interacted with members and providers via inbound calls.

● Managed over 50 member and provider calls. Assisted members with placing their Over-the-counter orders.

● Assisted providers with authorizations, claims, appeals, eligibility, and benefits eligibility.

● Maintained member and provider satisfaction with forward-thinking strategies focused on addressing member/provider needs and resolving concerns.

● Helped a large volume of members/ providers every day with a positive attitude and focus on customer satisfaction.

● Participated in team meetings and training sessions to stay informed about product updates and changes.

● Answered constant flow of members and providers calls with minimal wait times.

● Maintained member and provider satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

● Researched and analyzed eligibility, other health information, and group data for issue identification and root cause, developed and tested interim solutions, managed eligibility implementations, and monitored results. Job Gap: Due to Covid

Plastic Pack – McCalla, AL Jan 2017 - Apr 2018

Warehouse Worker

● Received, stored, and shipped merchandise that was stored inside warehouse.

● Worked under limited supervision following standardized practices and methods.

● Maintained database of packages and completed inspections.

● Produce and package over 1000 bottles per night.

● Pulled merchandise from inventory storage and documented quantities to maintain accuracy.

● Executed regular inventory counts and supply audits to monitor shrinkage and generate insights into purchasing decisions.

● Picked and packed order items.

● Inspected work areas for cleanliness and obstacles and removed cartons and boxes to keep work areas organized and hazard-free.

Home Health Aide New Iberia, LA (Direct Client) Nov 2014 - Jan 2016 Patient Service Representative

● Maintained a safe, secure, and healthy environment.

● Assisted with activities of daily living, personal hygiene, mobility and feeding.

● Handled light housekeeping duties, prepared meals, and ran errands.

● Completed daily logs documenting patient condition, activities, and any changes to patient care plan.

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