Customer Claims & Support Specialist
Resume:
BRITTANY HOLLMOND
Raeford, NC *****
**********@*****.***
Accommodating Customer Support Specialist with documented history of exceeding customer and patron expectations. Calm and composed in stressful situations with successful record of reducing customer dissatisfaction through acknowledgment, decisive communication and focused solutions. Expert at finding win-win solutions. Workers Compensation
Database Management
Policy understanding
File Management
Coverage Determination
Submitting insurance documents
Insurance collaboration
Verifying orders
Insurance Billing
HIPAA Compliance
Inventory Control
Schedule Management
Inventory Management
Workplace Safety
Inbound and Outbound Calling
Paperwork Processing
Data Entry
CRM Software
Technical Support
10/2015 to 06/2024
WORKING SOLUTIONS
Claims Representative
Reviewed and verified claim information to ensure accuracy of data and compliance with established policies. Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims. Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence. Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information. Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
Collaborated with other departments to resolve billing disputes or address customer concerns quickly. 10/2011 to 10/2015
CVS PHARMACY
Pharmacy Assistant
Performed administrative duties such as filing documents, faxing forms, answering phones. Assisted customers with prescription refills, requests for over-the-counter medications and other health care products.
Received telephone calls from physicians, nurses or other healthcare professionals requesting information about medications or supplies.
Tracked expiration dates for all drugs in stock and discarded expired items according to regulations. Provided filled prescriptions to customers, included medication information sheets and coordinated consults. Processed pharmacy payments by ringing up customers on cash register and handling cash and credit transactions.
08/2009 to 10/2011
RITE-AID PHARMACY
Shift Supervisor
Performed cash handling duties such as counting money, balancing registers, and preparing bank deposits. Identified areas of improvement within the department and implemented necessary changes. Assisted upper management with daily operations to meet standards of service and quality. Patrolled work areas to inspect operations, identify concerns, and implement corrective actions. Cultivated performance-based and collaborative culture by recognizing achievements and excellent teamwork. Complied with company safety procedures, policies and regulations to promote safe working environment. HIGH SCHOOL DIPLOMA 2008
Red Springs High School, Red Springs, NC
SUMMARY
SKILLS
EXPERIENCE
EDUCATION AND TRAINING
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