Call Center Specialist with Healthcare Experience

TESS STANLEY

623-***-**** Mesa, AZ - ***** **********@*****.***

SUMMARY

Experienced and empathetic Client Support Specialist with 10 years in the healthcare industry, skilled in managing patient and member complaints with professionalism and compassion. Adept at navigating complex healthcare regulations, including HIPAA and CMS guidelines, while ensuring timely and compliant resolution of escalated concerns. Proven track record of improving patient satisfaction, identifying systemic issues, and partnering with clinical and administrative teams to implement process improvements. Strong communicator with a commitment to patient advocacy and quality care.

PROFESSIONAL SKILLS

Computer Suave

Verbal and Written

Demonstrated experience in problem-solving with attention to detail

Excellent communication skills, both written and verbal

Proficiency with Microsoft Office applications

Knowledge of medical terminology

Clerical

Computer Proficiency

Time management skills and ability to prioritize

Empathy and Compassion skills

Proficiency with CRM software like Salesforce

Multi-Tasking

WORK EXPERIENCE

Client Support Specialist Jun 2017 – Feb 2025

Matrix Medical Network Scottsdale, AZ

Prepare detailed, well-organized reports that clearly outline findings and provide actionable recommendations.

Compiled and maintained medical charts and reports in complex digital databases.

Managing customer grievances and delivering prompt, compassionate, and effective resolutions.

Coordinated with credentialing teams to ensure provider qualifications met organizational standards, while also managing the ICIMIS & online application, and facilitating monoclonal antibody treatment scheduling.

Delivered administrative assistance to client's staff, ensuring smooth operations and efficient support.

Ensured adherence to regulatory standards and maintained professionalism in all customer service interactions.

Medicare Drug Benefit Specialist Sep 2015 – Jun 2017

Randstad Staffing on Site for CVS Health Scottdale, AZ

Ensured compliance with federal guidelines related to the Medicare Part D Prescription Drug Program.

Analyzed beneficiary data to assess eligibility for Part D late enrollment penalties based on coverage gaps.

Created a case file by gathering evidence that supports the client's claim, such as proof of previous coverage, medical records, or life-changing events that may have impacted their enrollment.

Payroll Specialist May 2000 – Aug 2007

Aaron's Sales and Lease Kennesaw, GA

Deliver exceptional service and ensure customer satisfaction by going the extra mile in every interaction.

Performed calculations in overtime, vacation, and sick hours to provide accurate data to payroll processing database.

Verified and submitted timekeeping information for accurate and efficient payroll processing.

Generated paper checks for employees and printed stubs for associates who received direct deposits to complete payroll distribution.

Manage background checks and account set-up for onboarding new recruits.

EDUCATION

Certificate: Medical Billing & Coding Mar 2022

Penn Foster College, Phoenix, AZ

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