Virtual Customer Service & Enrollment Specialist

Karen Walker

Wellington, FL ***** +1-561-***-**** ***********@*****.***

Professional Summary

Professional in virtual customer service with proven track record of enhancing customer experiences through effective

solutions. Known for strong team collaboration and adaptability to changing needs. Reliable in managing customer

interactions and utilizing advanced CRM tools.

Work Experience

Tax Preparer

Myra Tax Service Beaufort, SC

August 2012 to Present

• Provided exceptional customer service during peak tax season by remaining calm under pressure and addressing client

concerns promptly and professionally.

• Increased client satisfaction by providing accurate and timely tax preparation services.

• Assessed client tax situations to determine best filing options.

• Completed and filed returns with tax departments at local, state, and federal levels.

Provider Enrollment Specialist

Qualfon USA contract position Wellington, FL

September 2025 to March 2026

• Initiate and process enrollment applications for healthcare providers with various commercial and government payers.

• Verify provider credentials, licenses, and certifications to ensure they meet all payer participation requirements.

• Maintain and update provider data in enrollment systems and databases to ensure accuracy and integrity.

• Communicate directly with insurance companies to follow up on application statuses and resolve any enrollmentrelated issues.

• Manage the re-enrollment and revalidation process for existing providers to ensure their information remains current

with all networks.

• Serve as a direct point of contact for providers to assist them in completing necessary paperwork and understanding

enrollment procedures.

• Investigate and resolve claim submission issues and denials that are related to provider enrollment problems to ensure

proper reimbursement.

• Ensure all enrollment activities are conducted in compliance with healthcare regulations such as HIPAA and CMS

guidelines.

Risk Agent EDD Unemployment Cards

TTEC for Bank Of America Wellington, FL

February 2020 to June 2025

Conducted comprehensive assessments of dispute submissions to identify and investigate potential fraudulent

activities.•

Collaborated with team members to efficiently manage the entire dispute resolution process.• Monitored financial

transactions and account activities, using detection tools to identify and flag suspicious behavior.

Member Service Representative

Molina Health Care State Medicaid Doral, FL

November 2015 to January 2020

Cross-trained and served as backup for customer service representatives, ensuring continuity in service excellence.

• Addressed and resolved customer complaints effectively, promoting satisfaction and loyalty.

• Assisted members and providers by retrieving relevant information and offering clear explanations on plan benefits

and claim details.

Remote Billing Representative

Arise Virtual Solutions Lake Worth, FL

August 2012 to October 2015

• Identified, researched, and resolved billing variances to maintain system accuracy and currency.

• Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and

accurate payments.

• Coordinated with intermediate parties to obtain payments and resolve issues.

• Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.

#HRJ#d1eefc37-875c-4fec-a527-4e4c8e5d028d#

ROI Specialist

Health Port Technologies Palm Beach Gardens, FL

July 2006 to August 2015

Compiled and maintained comprehensive medical records for hospital and clinic patients, ensuring adherence to

administrative, ethical, and legal standards.• Processed and accurately managed patient information, aligning with

healthcare industry standards and numerical coding systems.• Generated detailed reports on patient health and mortality

data, ensuring consistency and confidentiality in record handling.Dealth Certificate Birth and Medical Records

Education

Medical Assistant (Diploma)

Florida Career College West Palm Beach, FL

February 2009 to June 2010

High School Diploma

General High School Norwalk, CT

September 1977 to June 1980

Upper secondary education

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