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Click here or scroll down to respond to this candidateCandidate's Name
Pittsburgh, PA Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLE Customer service expertise both in person and over the phone for over Street Address + years Most recent career in human relations with Cigna Healthcare Compared data with source documents, or re-enter data in verification format to detect errors Proofread errors and made corrections to ensure Street Address % accuracy Knowledgeable of all office machines, such as copiers, scanners, fax machines, and dual monitor computers Knowledgeable and proficient with Microsoft Office products such as Word, Excel and Outlook
Available to interview with 24 hr. notice Can speak some Spanish for problem -solving and guidance Willing to relocate: AnywhereAuthorized to work in the US for any employerWork ExperiencePatient Support SpecialistCignaHealthcare-RemoteFebruary 2024 to PresentUtilize Knowledge Base materials as a foundation for resolving inquiries Maintain confidentiality of patient and proprietary information Develop a working knowledge of company related security and privacy practices. Participate in continued education on product changes, new features and product launches Help improve the patient experience by sharing feedback with management to further develop the product, materials and processesPro Claim RepresentativeBlink Health-Robinson Township, PANovember 2023 to February 2024Collection of structured clinical data for prior authorization and non-formulary exception requests following the guidance provided in our online prior authorization tools and corresponding forms. Initial screening of requests based on guidance given by online prior authorization tools. Approves prior authorization requests if the data collected meets the approval specifications. Refers prior authorization requests that do not meet the approval specifications to a clinician for review. Independently responds to contacts ranging from routine to moderate complexity. May seek assistance with health care professionals for service issues of substantial complexity. Performs research to respond to inquiries and interprets policy provisions to determine the most effective response using established departmental procedures, HIPAA regulations, and corporate policies.PCOPeople's Gas Company-Pittsburgh, PAJune 2023 to November 2023June 2023 to Present responsible for satisfying a broad array of customer needs, resolving routine to complex billing issues, adhering to PUC guidelines and performing and maintaining credit and collection activities
Individuals will need to exercise judgment within a framework as established by supervision Answer inbound calls, and when required make outbound customer callsIndependently respond to and resolve customer questions, concerns, and complaints via calls and correspondenceProvides prompt and accurate service to promote an excellent customer experience while utilizing complex computer systemsIdentify, review and resolve complex billing issues including errorsPerform credit identification for new applicantsSchedule service orders to address service issues including emergency orders Assessing customer needs and educating customers on procedures and services Clarify information, research every issue and provide solutions and alternativesEnter customer meter reads utilizing complex SAP system to identify, track and document correspondence, issues, actions, and resolutionsProvide administrative and clerical support as needed within the Customer Service CenterPatient Support SpecialistConnectiveRx-Pittsburgh, PANovember 2022 to May 2023Prepare, submit and follow up on insurance appealsStays current on insurance policies and procedureWorks open balance accounts as assignedPrepare and submit appeals on denied charges based on insurance plan requirementsFollow up on unpaid charges and determine best method to collect open balances quickly Make corrections to charges as needed based on medical documentation (i.e add modifiers, duplicate denials, correction of date of service, diagnosis corrections) Maintain copies of pertinent documents until resolution of charge(s).Respond to insurance or patient telephone inquiries and correspondence regarding claims/reports.Handle inbound patient billing and making outbound collections phone callsUpdate account information as neededCorrect and update patient demographics accordinglyUse critical thinking to make sound clinical decisionsAdhere to ethical standards of conduct as well as applicable state and federal laws Provide effective oral or written nonverbal communication with patients and their families, colleagues, and health care providersProgram DirectorRemnant Ministries-Homestead, PADecember 2021 to October 2022Support CEO and Pastor with multiple housing units during all operations of the day with Men and Women previously incarcerated. Attend court proceedings and probation parole and house detainee meetings. Schedule medical and mental health appointments ensure health insurance and benefits are obtained. Maintain household duties and supervise and contribute to meal preparation. Adhere to all program rules and regulations maintain all paperwork and assist with shopping and money management. Resource NavigatorUnited Way (Nesco Resource)-RemoteSeptember 2019 to September 2021Customer service, counseling, resource provider, provide information, confidant Customer Service RepresentativeAdvent Global (UPS)-Crafton, PAOctober 2018 to December 2018Greet customers Answer questions Problem solving Ship packages Monetary and credit card management Distribute merchandise Recruit for drivers and helpers Orchestrated interviewsData Entry ClerkBNY Mellon-Pittsburgh, PAFebruary 2016 to January 2018 Processed checks on a payee keying system in accurately and on a timed schedule Proofread errors and made corrections to ensure 100% accuracy Processed signature cards Cross trained for other BNY Mellon products and systems Customer Service RepresentativeSheetz-Robinson Township, PANovember 2015 to January 2016 Received payment by cash, check, credit cards, vouchers, or automatic debits Assisted customers by providing information and resolving their complaints Established or identify prices of goods, services or admission, and tabulate bills using calculators, cash registers, or optical price scanners Greeted customers entering establishmentsData Entry ClerkNationwide Bank-Pittsburgh, PASeptember 2015 to November 2015 Compiled, sorted and verified the accuracy of data before it is entered Compared data with source documents, or re-enter data in verification format to detect errors Stored completed documents in appropriate locationsDebt CollectorCardwork Services-Pittsburgh, PAMarch 2015 to May 2015 Placed outbound calls to arrange for debt repayment or established repayment schedules, based on customers' financial situations Located and notified customers of delinquent accounts by mail, telephone, or personal visits to solicit payment Persuaded customers to pay amounts due on credit accounts, damage claims, or non-payable checks, or to return merchandise Achieved personal and team goals daily and on a quarterly level Conferred with customers by telephone to determine reasons for overdue payments and to review the terms of sales, service, or credit contractsCustomer Service RepresentativeIbex Global, (TRG)-Robinson Township, PAMay 2014 to December 2014 Conferred with customers by telephone to provide information about products or services, take or enter orders, cancel accounts Sold Credit cards as well as Cross sell other bank products to potential customers Data captured correct information for existing customers Initiated customers in receiving appointment from bank representatives Processed card activationsServerParkhurst Dining-Shadyside, PASeptember 2013 to January 2014 Stocked supplies and food items Cleaned work area and light janitorial duties Greeted and served faculty and studentsPrep CookPF Changs-Homestead, PASeptember 2012 to March 2013 Washed and prepared vegetables and appetizers Prepared desserts Prepared sea food and poultry items Ensured work area was thoroughly cleaned and sanitized always CashierUniversity of Pittsburgh-Oakland, PAJuly 2011 to January 2012 Received payments by validating credit charges; approving checks; accepting currency; calculating and issuing change Reconciled cash drawer by proving cash transactions; listing checks and credit card charge Cashier/Hostess/CateringAubopain-Pittsburgh, PAJune 2010 to June 2011 Greeted incoming and departing guests warmly with a genuine smile and eye contact; escorted them to assigned dining area; presented menus; announced waiter's name Informed guests of current promotion and who will be serving them to ensure a smooth handoff to the service staff Received payments by validating credit charges; approving checks; accepting currency; calculating and issuing changeEducationHigh School DiplomaCommunity School East - Forest Hills, PAAugust 2002 to May 2006Skills Call Center (10+ years) CSR (5 years) Computer Skills (10+ years) (10+ years) Customer Service 10-Key (3 years) (5 years) Order Entry Typing (5 years) POS (5 years) Proofreading (7 years) Catering (10+ years) Cold Calling Host/Hostess Microsoft Outlook Event Planning English Time management Leadership Hospitality (10+ years) Phone etiquette (10+ years) Senior care iOS (10+ years) Mac OS (10+ years) 4G/LTE (10+ years) Analysis skills Recruiting (1 year) Windows Telecommunication (7 years) Office experience Computer skills Computer literacy Front desk Organizational skills Data entry Administrative experience Clerical experience Word processing Multi-line phone systems Filing Medical terminology Documentation review Case management Care plans Banking Customer service Typing Sales Debits & credits Microsoft Access Live chat Conflict management Cold calling Proofreading Cash handling CRM software Financial services Clerical experience Telemarketing Interviewing Google Suite Windows Salesforce Leadership Medical terminology Software troubleshooting Data collection Order entry Payroll Human resources Remote access software Public relations Order fulfillment Recruiting Telecommunication Quality assurance Documentation review Supervising experience Hospitality LAN Project management software Supervising experience Data collection Clerical experience Public relations Customer service Conflict management Typing Medical terminology Live chat Software troubleshooting Remote access software Leadership Technical support Microsoft Access Cooking Telecommunication Cash handling 4G/LTE Cold calling Computer networking Google Suite Epic Human resources Hospitality Sales Databases Telemarketing Windows Negotiation 5G LAN Banking Proofreading Payroll Debits & credits Help desk Research Project management software AWS SQL Recruiting Order entry Mac OS Quality assurance SAP ERP Salesforce |
