Customer Service Representative - Healthcare Benefits Support
Resume:
Edewe Bolton
Dallas, Texas ***********@*****.*** 617-***-**** LinkedIn.com/in/omoyeoziegbe
PROFESSIONAL SUMMARY
Dedicated Customer Service Representative with 6+ years of experience delivering exceptional support in fast-paced, high-volume customer service environments. Skilled in handling inbound and outbound inquiries, resolving customer concerns, managing accounts, and providing accurate information across phone, email, chat, and CRM platforms. Recognized for excellent communication, active listening, problem-solving, and conflict resolution skills while consistently meeting quality, productivity, and customer satisfaction goals. Experienced in building positive customer relationships, maintaining accurate documentation, and collaborating with cross-functional teams to improve service delivery. Committed to providing professional, empathetic, and efficient customer experiences that promote customer loyalty and organizational success. Professional Experience
Customer Service Representative Dynamic Agile Consulting Dallas, Texas January 2022 – Present
Handle high-volume inbound calls supporting patients, providers, pharmacies, and insurance companies regarding benefits, eligibility, medication access, and financial assistance programs.
Verify medical and pharmacy benefits with commercial insurance, Medicare, Medicaid, and managed care organizations.
Conduct annual benefit reverification to ensure uninterrupted patient access to prescribed therapies.
Research and resolve insurance claim denials, payment discrepancies, prior authorization issues, and coverage gaps.
Coordinate with providers, specialty pharmacies, and internal departments to obtain required documentation and expedite patient enrollment.
Determine patient eligibility for copay assistance, Patient Assistance Programs (PAP), Medicaid, and other manufacturer support programs.
Educate patients on insurance benefits, deductibles, copays, and available financial assistance options.
Accurately document all customer interactions while maintaining HIPAA and company compliance standards.
Monitor trends involving claim denials, billing issues, reimbursement delays, and pricing discrepancies, escalating issues to program leadership when necessary.
Maintain quality standards across phone, email, fax, and written communications.
Work independently within performance metrics while consistently meeting productivity, quality, and customer satisfaction goals.
Deliver empathetic customer service while resolving complex patient concerns in a fast- paced healthcare environment.
Patient Access Specialist Thanos Consulting Dallas, Texas June 2020 – December 2021
Supported high-volume customer service operations while managing complex patient requests.
Utilized Salesforce and healthcare systems to process registrations, insurance verification, scheduling, and documentation.
Resolved patient inquiries efficiently through phone, email, and online support channels.
Maintained accurate patient records and ensured timely documentation of all interactions.
Collaborated with clinical and financial teams to improve patient experience and operational efficiency.
Built strong relationships with patients and providers through proactive communication and timely issue resolution.
Participated in quality assurance initiatives that improved service consistency and operational performance.
Consistently met departmental productivity and customer satisfaction goals. Customer Care Associate Ruby Secrets Inc Remote May 2018 – May 2020
Delivered exceptional customer support through phone, email, CRM, and live chat while assisting approximately 50+ customers daily.
Scheduled appointments, completed customer registrations, and responded to product and service inquiries.
Educated customers on available services, company policies, and available solutions.
Coordinated appointments based on urgency, customer needs, and scheduling availability.
Resolved customer complaints using active listening, problem-solving, and conflict resolution techniques.
Collaborated with internal teams to improve customer experience and streamline service delivery.
Consistently exceeded customer satisfaction expectations through professional and timely communication.
Increased product sales through effective upselling and cross-selling strategies.
Provided first-level technical support, successfully resolving the majority of customer issues during the initial interaction.
Maintained professionalism and empathy while managing escalated customer situations.
Assisted with scheduling, administrative support, and customer record maintenance. Education
Bachelor's Degree
University of Benin, Nigeria
Certifications
HIPAA Awareness Training – HIPAATraining.com
Customer Service Excellence – LinkedIn Learning
Medical Terminology Essentials – Coursera
Technical Skills
Systems: Epic, Cerner, Salesforce, Microsoft Office Suite, Outlook, Teams, Zoom Tools: Avaya, Five9, Genesys Cloud, ServiceNow
Typing Speed: 65+ WPM Accuracy: 98%
Core Competencies
Patient Customer Service
Healthcare Customer Support
Insurance Verification
Benefits Investigation
HIPAA Compliance
Patient Assistance Programs (PAP)
Copay Assistance Programs
Medicare & Medicaid Verification
Pharmacy Coordination
Claims Resolution
Prior Authorization Support
CRM Systems
Salesforce
Customer Relationship Management
Call Center Operations
Inbound & Outbound Calls
Documentation & Data Entry
Customer De-escalation
Problem Solving
Team Collaboration
Process Improvement
Multitasking
Communication
Time Management
Microsoft Office Suite
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