Customer Service Claims & Payments Specialist
Resume:
Charles Ola
Richmond, TX •
• ***************@*****.***
Professional Summary
Detail-oriented customer service professional with over 5 years of experience in high-volume call centers, specializing in claims processing, customer portal assistance, payment processing, relationship management, eligibility inquiries, overpayment recovery, and issue resolution. Proven ability to multitask across multiple systems with a 99% accuracy rate while maintaining high customer satisfaction standards. Skilled in communication, problem-solving, and adapting to dynamic customer needs in fast-paced environment
Customer Service Representative - Cloud & Prem Inc
September 2021 – Present
●Handled high volumes of inbound calls from customers, caregivers, and referral partners regarding medical supplies, consistently achieving a 90% average customer satisfaction score.
●Managed sensitive and complex inquiries while maintaining professionalism, successfully meeting or exceeding daily and weekly call-handling targets.
●Processed new and existing customer orders with 98% accuracy, ensuring complete insurance verification and timely payment processing.
●Utilized multiple software systems and company hardware efficiently, resulting in a 20% reduction in average handling time (AHT) while maintaining quality service.
●Partnered with Supervisors and Team Leads to resolve escalated or complex cases, contributing to improved first-call resolution and faster case completion.
●Collaborated with cross-functional teams to identify workflow improvements, share best practices, and enhance service delivery. Led training for new hires, increasing onboarding efficiency by 25%.
●Adapted quickly to evolving procedures and technologies, maintaining a positive and solution-oriented attitude that contributed to a 10% increase in overall team morale.
●Documented all customer interactions with a high degree of accuracy, reducing escalated cases by 30% through proactive conflict resolution.
●Prioritized tasks effectively during peak periods, consistently meeting productivity goals and improving AHT by 15% without compromising service standards.
●Maintained an empathetic and customer-focused approach, strengthening rapport with customers and supporting a strong team culture that contributed to high employee retention rates.
Education
High School Diploma
Customer Support Client Relations First Contact Resolution High Volume Call Handling Multichannel Communication (Phone, Email, Chat) Issue Resolution Problem Solving Conflict De escalation Active Listening Empathy & Professionalism Service Recovery Quality Assurance Customer Satisfaction (CSAT) Ticket Management Case Documentation Insurance Verification Prior Authorization HIPAA Compliance Medical Records Coordination Claims Processing Appointment Scheduling EMR/EHR Systems (Epic, Athena, Cerner) Provider Communication Eligibility & Benefits Review Medical Terminology Pharmacy Coordination Care Coordination Intake & Registration Billing Support Payment Processing Fraud Prevention Identity Verification KYC (Know Your Customer) Financial Compliance Transaction Disputes Loan Servicing Escalation Management Risk Assessment Regulatory Adherence Data Accuracy Secure Information Handling EMR/EHR Platforms (Epic, Athena, eClinicalWorks) Call Center Software (Five9, NICE, Genesys) Ticketing Systems Knowledge Base Tools Microsoft Office Suite Data Entry & Documentation Workflow Optimization Adaptability Time Management Multitasking Attention to Detail Team Collaboration Critical Thinking Professional Demeanor Reliability Decision Making Patience Organization Accountability
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