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Click here or scroll down to respond to this candidateCandidate's Name
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Phone Number: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLE OBJECTIVESeeking to obtain employment in a customer service based position to help manage and direct the system of quality customer service.EDUCATIONHS Diploma, General Studies, Greenville High School (Aug 2017 May 2021) Greenville, MS 38703 SKILLS Microsoft Office Suite: Excel, Power Point, Publisher, Word, Access Administrative Tasks (Budgeting, Quotes, Excess Processes, Memos and Reports) Operating Systems: Windows 7/8/10 Exceptional judgment and strategic planning, thinking skills and interpersonal skills. Ability to work professionally with sensitive items/materials, proprietary data and information while maintaining confidentiality; record keeping and multi-tasking skill set. Exhibits excellent organizational and problem-solving skills and displays a strong work ethic. Ability to work well independently or in a group setting Exemplifies strong customer service skillsEXPERIENCECustomer Service Escalation Coordinator, Humana Healthcare February 2022 Present (Remote WFH) Manage escalated customer complaints, executing strategic resolutions for issues that are beyond the scope of frontline services, ultimately driving customer satisfaction and loyalty. Conduct in-depth assessments of customer concerns, utilizing active listening and critical thinking skills to design the most effective course of action, resulting in swift, satisfactory resolutions. Advocate for customers by communicating their feedback to cross-functional teams, influencing product improvements and service enhancements. Inform and educate customers about the extensive range of Humanas products and services, empowering them to make informed decisions that suit their unique needs. Continually enhance the overall customer experience by proactively identifying opportunities for process improvements and initiating relevant solutions.Claims Benefit Operations Specialist I, AetnaJune 2021 February 2022 (Remote WFH) Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process. Proofs claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre- coding requirements. Utilizes all applicable system functions available ensuring accurate and timely claim processing REFERENCES Available Upon Request |
