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Michelle ReneDieffenbacherCUSTOMER SERVICE/RESOLUTION EXPERTWesley Chapel, FL PHONE NUMBER AVAILABLE EMAIL AVAILABLE ObjectiveTo obtain a challenging position in customer care, grievance resolution or data entry in a dynamic and innovative organization.A customer service or claims service position that will utilize customer service skills and claims for further advancement in either field.Qualification Highlights*Served as a trainer/mentor for new hires, teaching practical applications and maintaining quality control.*Recognized for long hours, commitment to customers, and attention to detail, professionalism, and follow-up.*Demonstrated ability to meet the needs of patrons, dependable, hardworking, reliable and punctual.*Resourceful, energetic, competent, multi-task and results-oriented ExperienceUltimate Staffing2024Customer Service Contract with Prime Therapeutics- pharmacy tech 1 Wipro, Tampa Florida March 2022 to Sept 2023Customer Service Contract for one year remote with Molina Healthcare. Medicare Team*Reviewed prior authorization claims for Ultimate staffing numerous accounts.*Assisted on researching patient's coverages*Researched accurate coverage, conducted outreach for providers to collect additional information to process coverage and monitored times for completion.* Maintained compliance and Hipaa guidelines at all times.*Inbound Medicare members associate.*Assisted Customer's with updated balances on their Molina care card. Foster/Adoption experience, remote from home Feb 2013 to March 2022 Childcare: Responsibilities in caring for and nurturing foster children Emotional Support: provided emotional support and created a safe environment. Conflict resolution: Was able to resolve conflicts and manage difficult situations. In the case of childrens behavior or actions. Advocacy: Advocated in court on behalf of foster children to enable reunification of families. Advocated the importance of foster care by guest speaking at foster training classes and guest speaking at events and in the media. Time Management: was responsible for balancing foster parenting with other responsibilities. I adopted and raised three children during this time. Started a yearly Christmas toy drive for children in foster care community-New Life VillageHealthesystems, Tampa, Florida 2012-2013 Customer Claims Specialist Took inbound work comp pharmaceutical orders, updates, resolves phone inquiries related to claims adjudication, eligibility verification, prior authorization and some Biling Verification. Tech Health, Inc. Tampa, Florida 2007-2011 Senior Claims Representative Took inbound medical claims from start to finish for work comp claims- this incorporated assements, doctor appointments, medical supplies, surgery scheduling and prostectics. The Home Depot, Riverview, Florida 2004-2006 Trained new employees. Resolved with all aspects of customer care and order entry, research. EducationConcorde Career Institute, Tampa, Florida 1998M.A., Medical AssistantHillsborough Community College, Brandon Florida 2002 A.A., Did Not GraduateLiberal Arts ClassesBrandon High School, Brandon, Florida 1991H.S., VariousSkills Positive attitude and a willingness to learn and grow Ability to identify customer needs over the phone.*Maintained compliance and Hipaa guidelines at all times.*Assisted Pharmacy with obtaining script and documentation to support Prior auth process.*Assisted members with using their debit cards for groceries and or over the counter supplies. Able to work collaboratively with colleagues and staff to create a high-quality result with team oriented environment. Problem solving Communication Training Claims investigation Sales consultation Familiar with Salesforce and Salesforce too Demonstrated ability to use discretion, make sound decisions, and confidentiality Reliable, time management skills and organizational skills Honors Wipro team player and customer service call awards USAA customer service Pride awards Tech Health Outstanding Customer awards