Customer Service & Data Entry Specialist

Tyesha Kelly

410-***-**** ***************@*****.***

Objective

Energetic Customer Service Specialist with strong time management skills, exceptional computer aptitude, and outstanding telephone etiquette who thrives in a fast-paced, dynamic environment. Proven ability to manage patient health information and support the release of information process with keen attention to detail and adherence to HIPAA compliance standards. Experienced in providing customer support through active listening and problem- solving in high customer volume environments, including data entry and management within internal systems and EMR platforms. Previous managerial/supervisory experience, including hiring, training, and coaching. Excels at prioritizing, completing multiple tasks simultaneously, and following through to achieve project goals. Familiar with major computer software and possess a positive attitude. Aiming to leverage proven skills to effectively fill the Data Entry Specialist role at Sharecare.

Core Qualifications

Great understanding of insurance types, policies, procedures, coverage, prices. Exceptional customer service skills with customers as well as providers. Proficient in MS Office and data entry programs used to collect insurance information, supporting efficient data management.

Thorough and meticulous in all paperwork and data entry, ensuring accuracy and confidentiality. Problem-solving skills needed to assist customers with claims and navigate stressful situations with ease. Excellent mathematical skills for easy calculations. Proven loyalty with a company growth of knowledge and advancement of position. Ability to calm irate, anxious, or grieving customers.

Areas Of Expertise

Computer literate with an above-average typing speed and strong manual dexterity for extended periods of typing. Superb verbal and written communication skills, including professional communication and courteous interaction. Thorough, with excellent listening skills and a high degree of Attention to Detail. Proficient in data management and EMR systems.

Understanding of HIPAA and patient health information security protocols. Work Experience

Advocate, United Healthcare, — September 2021 - May 2025 Utilized different internal systems to process payments and manage patient accounts. Reviewed Explanation of Benefits (EOBs) to assist members with inquiries. Assisted with scheduling appointments and provided support for benefits questions. Collaborated with doctors' offices and collection agencies to resolve member payment or inquiry issues. Conducted outreach to members and providers to resolve member issues, demonstrating strong customer service and problem-solving skills.

Health Insurance Customer Service Representative, Affordable Health Insurance Inc, — January 2019 - March 2021 Remained up-to-date with changes in plans and tariffs, ensuring accurate information dissemination. Greeted customers in a friendly, professional manner using the suggested script, embodying courteous service. Answered telephonic and e-mail inquiries in a timely manner, maintaining efficient communication. Furnished members and health care practitioners with details regarding member benefits, supporting care management.

Granted pre-authorizations for medical treatment, if covered, and advised members of outstanding co-payments. Provided extant and prospective members with details of network providers. Processed member plan cancellations upon request or due to non-payment, adhering to company procedures. Ensured workspace remained tidy and equipped with all relevant tools and resources, demonstrating organizational skills.

Insurance Personal Lines Customer Service, Work At Home Vintage Experts, — June 2016 - January 2019 Researched and answered client and underwriter calls, providing accurate information. Advised clients regarding insurance coverage and risk management issues, demonstrating a strong understanding of policies.

Processed insurance policy changes, renewals, and cancellations with meticulous data entry. Fostered and maintained good working relationships with clients, insurance company underwriters, and real estate sales associates.

Healthcare Customer Service, JHH, — June 2011 - June 2016 Welcomed patients at the CSR counter and provided assistance with facility services and doctor availability. Obtained necessary patient information, including medical histories and insurance details, ensuring proper processing and recording within health systems.

Contacted insurance companies to verify coverage and benefits, providing doctors with feedback on coverage and copays, supporting data-driven healthcare decisions. Assisted patients in understanding their insurance coverage and calculated/presented copays accurately. Executed medical equipment and supplies orders from vendors and suppliers, ensuring timely delivery. Followed up with doctors and nurses to obtain necessary information to complete patient records, ensuring data accuracy and confidentiality.

Education

High School Diploma, Carver Vo-Technical High School, — June 2011 Graduated with a 3.0 GPA.

Concentration in General Studies.

Deans scholarship recipient.

Scholars Award Recipient.

Achievement Academy Award.

References

Available upon request.

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