Customer Service
Resume:
PROFESSIONAL SUMMARY
Detail-oriented and methodical, skilled at managing employee
benefits programs, ensuring compliance with regulations, and resolving benefits-related inquiries with minimal errors. Strong work ethic combined with expertise in benefit plan administration, accurate data entry, and maintaining organized records, supporting efficient operations and delivering high- quality results.
EXPERIENCE
Verification Specialist
February 2026 - July 2026 Ortho Arizona, Chandler, AZ Benefits Representative
October 2016 - April 2025 CVS Health, Chandler, AZ
Applied strong organizational skills in managing multiple tasks simultaneously while meeting tight deadlines.
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Verified insurance coverage and eligibility prior to appointments and procedures.
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Reviewed patient deductibles and copays and entered into billing system.
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Followed established verification processes to confirm insurance benefits, medical necessity, and authorization.
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Assessed insurance policy terms to determine patient coverage and limitations.
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Worked within EMR system to document results of patient insurance verification.
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Answered questions from patients and clerical staff regarding coverage.
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Calculated estimated patient financial responsibility via estimation tool.
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• Scheduled appointments for patients,
Serve customers regarding their prior authorizations for specialty medications.
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Utilize various computer systems to find members, providers, and facilities.
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Outbound calls to insurance, doctors and patients regarding status of medications
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CONTACT
***.*******@*****.***
Chandler, AZ 85286
SKILLS
Customer service and client
relations
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• Administrative support
• Insurance knowledge
• Data entry and order processing
• Teaching and coaching
• Communication skills
• Problem solving and critical thinking
• Team collaboration
• Adaptability
LANGUAGES
• English
RUTH "LIZ" RILEY
CUSTOMER SERVICE REPRESENTATIVE
Customer Service Representative
April 2011 - June 2015 MedImpact, Tempe, AZ
Administered claims processing services by resolving any discrepancies or errors in a timely manner.
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Serviced pharmacy, physician and member accounts for this nationwide privately held pharmacy benefit manager.
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Managed pharmacy, physician and member calls processing claims, authorizations, overrides, reimbursements, formularies, benefits, network pharmacies and eligibility.
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Developed strong customer relationships and loyalty through effective communication.
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Utilized problem-solving techniques to identify solutions for complex customer inquiries.
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EDUCATION
Bachelor of Arts in Health & Physical Education
University of Missouri
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