| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Indianapolis, IN Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLESkills and Accomplishments Excellent customer service skills that build high levels of customer satisfaction Fluent in English, Spanish and French Excellent verbal and written communication skills Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Management and leadership experience Effective people skills and sensitivities when dealing with others Vast experience working remotely WFH Strong attention to details and dedication to achieve results Excellent work ethic and discipline Highly motivated, self-starter with ability to work independently and as a team to achieve goals and objectives Quick and avid learner with an inquisitive mind Outstanding presentation skills (technical and soft skills) Strong leadership skills Superb problem solving skills Prioritize all projects with varying deadlines Thrive in a fast paced, start-up like environment Willing to relocate: AnywhereAuthorized to work in the US for any employerWork ExperienceTier 2 Medical Claim AnalystElevance Health-Indianapolis, INMarch 2023 to Present Manage a case load of approximately 130 claims per day Verify and determine applicability of coverage Conduct timely and thorough investigations per company procedures Review files on a timely diary for reserving adequacy and resolution plans Evaluate and adjust claims within authority level Application of policy and provider contract provisions to determine if a claim is payable. If additional information is needed, or if a claim should be denied. Determine the status of medical claims through research Reviewing charges, and use of payment or denial codes within established guidelines and standards Maintenance of records, files, and documentation Meet the standards of department production and quality standards Follow all policies and procedures established for the department. Analyze and process claims in accordance with plan provisions Maintain compliance with claim routing and inventory control procedures. Document, track and resolve all plan providers' claims projects. Adhere to all statutory and regulatory fair claims practices. Maintain the privacy, confidentiality and security of patients' personal health information Adhere strictly to all HIPAA and Government guidelines or regulations Customer Service Representative BiotelWorking Solutions-RemoteJune 2022 to March 2023 Manage incoming and out-going call activity related to customer service. Provide tech support to callers regarding their heart monitor Initiates the set-up of new Bio Tel Heart devices Provides user training as needed. Coordinate shipment of devices to patients' home Ensure every request is handled promptly. Process all email requests timely. Document all patient account contact in patient file. Handle requests for reports/medical records Involve supervisory staff when necessary and makes recommendations for process improvement. Follow all policies, procedures and processes. Analyze problems and provides information/solutions. Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develop and maintain positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Provide external and internal customers with requested information. Place follow-up telephone calls to answer customer questions that are routine in nature. Maintain the privacy, confidentiality and security of patients' personal health information Adhere strictly to all HIPAA and Government guidelines or regulations Facilitator, Learning Experience GuideOmni Interactions, Inc.-Indianapolis, INOctober 2021 to July 2022 Provide education, resources, and tools to new hires on products, services, and processes to achieve their certification required to support client customers Support learners with their business partnership with Omni in a blended learning environment (live, virtual classes and eLearning) Identify students' knowledge gaps and quickly address their needs to ensure successful certification Responsible for attendance, performance, and certification tracking and reporting Escalate technical or performance related issues as appropriate Follow agendas and guides to lead agents to their certification success Responsible for delivering content as designed and to validate of readiness including hands-on activities, mock calls [chats, emails, text], and other real-life knowledge checks to certify workers are ready to represent the clients brands with excellence. Educate new hires on products, services, and processes to follow for the client Provide in person (virtual) facilitation for new and existing hires Work as an agent when not facilitating classes Isolate learning deficiencies and provide knowledge to bridge gaps Share information with Leadership Team as appropriate Use various quality monitoring tools to analyze data and track trends Deliver content for various courses Develop improvement programs focused on immediate and continuous improvement related to certification processes Complete department special projects as assigned by the Department Manager Perform any other task or assignment as deemed necessary by the organization. Schedule events and resources within the company Bilingual Customer Service Representative- Turbotax Working Solutions-Indianapolis, INDecember 2021 to April 2022 Provide customer support via phone both in English and Spanish. Assist customers with Turbotax software navigation Help them locate previous years' tax returns and amendments Use virtual tools and screen share to review customers' tax returns Answer general questions or problems Assist taxpayers file their return Check status of filed tax returns Advise of rejection reason and how to refile Help customer recover access to their online account Troubleshoot website issues Use critical thinking and multi-tasking capabilities to resolve issues Escalate when necessary to a tax expert Handle technical support questions via phone, with video capability. Research, analyze, and determine an appropriate course of action for TurboTax customers Document all issues, resolution, and follow-up action Answer inbound customer service calls Quickly help customers with good solutions Solve problems in a creative way Document details of calls and customer interactions in the appropriate systems Type and talk at the same time Navigate multiple systems, programs, and screens at the same time Customer Service Representative- FISOmni Interactions-RemoteJuly 2021 to November 2021 Provide customer service via phone regarding prepaid card solutions Handle customer inquiries and resolve basic support issues such as balance and transaction inquiries, card activations and delivery inquiries Receive inbound customer service / financial customer service calls Update customer information and ensure accurate entry of contact information Troubleshoot customer problems, identify and solve root cause of problems Provide dedicated banking customer service via phone Update customer information and ensure accurate entry of contact information Troubleshoot customer problems, and identifying root cause of problems Track and document inbound support requests Report cards lost and reissuing them Process disputes Perform account maintenance Maintain the security and privacy of cardholders' accounts Document each account after customer interaction Covid 19 Vaccine Appointment Scheduler- WalgreensOmni Interactions-RemoteApril 2021 to July 2021 Schedule patient vaccine appointments via phone Respond to callers non clinical questions Provide caller with a list of appointment options Answer questions about the COVID-19 vaccination process Check appointments availability in the patient's area Enter customer biometrics information Confirm appointment time and date Edit, reschedule and cancel appointments Follow all policies and procedures regarding case scheduling appropriately Maintain effective communication practices while talking to patients to schedule their appointments Complete patient documentation and case information in a timely manner Maintain the privacy,confidentiality and security of their personal health information Adhere strictly to all HIPAA and Government guidelines or regulations Customer Service Representative- TurbotaxOmni Interactions, Inc.-RemoteFebruary 2021 to May 2021 Provide customer support via phone and chat. Assist customers with Turbotax software navigation Help them locate previous years' tax returns and amendments Use virtual tools and screen share to review customers' tax returns Answer general questions or problems Assist taxpayers file their return Check status of filed tax returns Advise of rejection reason and how to refile Help customer recover access to their online account Troubleshoot website issues Use critical thinking and multi-tasking capabilities to resolve issues Escalate when necessary to a tax expert Handle technical support questions via phone, with video capability. Research, analyze, and determine an appropriate course of action for TurboTax customers Document all issues, resolution, and follow-up action Patient Care SchedulerCareCentrix-RemoteNovember 2020 to February 2021 Assist patients and representatives order medical supplies and home health services. Coordinate home health visits as requested by the ordering physician Maintain the security and privacy of patients' personal health information. Collect, interpret, verify, and accurately enter data from referral sources Complete paperwork to process patients' orders. Work closely with health plans/payers and maintain strong business relationships. Ensure the patient qualifies for the type and quantity of products ordered based upon the patients insurance and/or contract guidelines. Obtain insurance authorization when necessary. Provide appropriate issue resolution and/or escalation when needed. Advise of order status and delivery timeframes Contact ordering physician's office to facilitate patient care Front Desk AgentDiallo Auto Repair-Indianapolis, INOctober 2019 to November 2020 Greet customers entering the building, answering any questions, providing directions Alert staff when someone is there to meet or visit them Answer a multiple line phone system, manage calls by routing them to the proper extensions or taking messages Accept deliveries and mail, organize them to be distributed to the correct recipients using the office mailing system and ensure they get to the recipient in a timely manner Keep an inventory of materials and product in stock Ordering auto parts and supplies when running low Manage outgoing mail and packages for pickup Serve as the face of the company, offering friendly service to those entering the building or calling in on the phone Assist customers to retrieve their vehicles once repairs are complete Maintain the reception area, keeping it clean and free of clutter Handle filing and data entry as requested Process payments Write invoices and credit memosBilingual Customer Service RepresentativeTotal System-Columbus, GAOctober 2016 to October 2019 Provide financial customer service to cardholders both in English and Spanish. Perform maintenance on credit card accounts Safeguard the safety and privacy of customers' personal information. Resolve basic payment and account related requests such as balance inquiry,etc... Do card activations, payments, name and address updates for card holders Notate and documentate all actions taken on cardholders accounts. Enter required data into client provided systems and databases. Determine basic reasons for customer issues such as decline reasons, etc Review account transaction with customers fro any potential fraud Report and dispute fraudulent charges Refer compromised accounts to the Risk department for further investigation Replace damaged, lost or stolen cards in compliance with all security protocols Perform balance transfers Advise cardholders of account status Refer unresolved customer grievances and requests to Supervisor or designated departments for further investigation and resolution.Medical ReceptionistPinnacle Family Medicine-Columbus, GAJanuary 2016 to September 2016 Greet and welcome patients as soon as they arrive at the office Direct visitors to the appropriate Doctor Schedule patients' appointments Manage physicians' schedules Answer, screen and forward incoming phone calls Perform patients' intake and enter their information in the systems Ensure reception area is tidy and presentable, with all necessary stationery and material Provide basic and accurate information in-person and via phone / email Receive, sort and distribute daily mail / deliveries Provide clerical and secretarial support services Maintain office security by following safety procedures and controlling access via the reception desk(monitor logbook, issue visitor badges) Update calendars and schedule meetings Perform other clerical receptionist duties such as filing, photocopying, transcribing and faxing Process payments Maintain the security and privacy of patients' personal health information in compliance with HIPAA SecretaryZion African Ministry-Phenix City, ALJune 2014 to December 2015 answer calls, take messages and handle correspondence maintain diaries and arrange appointments type, prepare and collate reports file documents organize and service meetings (producing agendas and taking minutes) manage databases prioritize workloads implement new procedures and administrative systems act as liaison with relevant organisations and clients coordinate mail-shots and similar publicity tasks log and process bills or expenses communicate verbally and in writing to answer inquiries and provide information coordinate the flow of information with internal and external contacts operate office equipment manage office suppliesAdministrative assistantNLP Expert-CasablancaOctober 2011 to November 2013 prepare and manage correspondence, reports and documents organize and coordinate meetings, conferences, travel arrangements take,type and distribute minutes of meetings implement and maintain office systems maintain schedules and calendars arrange and confirm appointments organize internal and external events handle incoming emails, mail and other material set up and maintain document management systems set up work procedures collate information maintain databasesEducationGEDColumbus Technical College Adult Education - Columbus, GA January 2016 to April 2016Bachelor' s in Business AdministrationJean Moulin College - FranceSeptember 2005 to August 2009Skills Bilingual Spanish Customer Service Bilingual French Call Center CSR Fluent Fulani Multilingual Translation ICD-10 Medical terminology Windows English Natural Language Processing remote work (3 years) Conflict management Relationship management Salesforce (1 year) Tableau Amazon Connect (1 year) Slack (1 year) Microsoft Teams (1 year) Zendesk Google Docs Microsoft Excel Project management Training & development (Less than 1 year) Microsoft Office Microsoft Powerpoint Transcription Software Troubleshooting Medical Receptionist Live Chat Technical Support Teaching (1 year) Google Docs Windows Salesforce Learning technology Customer service Clerical experience Documentation review HIPAA Medical records Medical terminology Conflict management Project management Teaching Leadership Technical support English Training & development Presentation skills Tutoring Data Analysis Adult Education Microsoft Office Medical billing Communication skills Analysis skills Software troubleshooting Data analysis skills Medical Scheduling facets (1 year) Macess (1 year) Medicaid (1 year) Medicare (1 year) Data entry (10+ years)Languages Spanish - Fluent French - FluentAdditional Information Computer skills: Microsoft Word, Excel, Access and PowerPoint, Salesforce, Facets, Macess, Webex, Zoom, Microsoft Teams, Slack |
