Professional with strong background in customer interactions, data entry, insurance verification, and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
18
18
years of professional experience
Work History
Customer Service Rep
Highmark Health
07.2024 - 05.2025
Spoke with members and providers over the phone on a daily basis regarding eligibility, benefits and claims
Scheduled dental appointments for members
Made sure all call inquiries were closed in a timely manner and routed to the appropriate departments
Spoke with other insurance companies regarding eligibility and coordination of benefits
Reviewed claims to ensure that they were correctly processed
Logged and documented in detail the entirety and nature of each call from members, providers, and other insurance companies
Entered in member and provider information into the systems such as DOB, address, phone number, etc.
Checked and responded to incoming emails that were received from members and providers in a timely manner
Assisted members over the phone with locating in-network dental providers
Assisted members over the phone with understanding billing inquiries that were billed to them from providers after services were rendered
Customer Service Rep
Arkansas Blue Cross and Blue Shield
09.2014 - 11.2021
Spoke with members and providers over the phone on a daily basis regarding eligibility, benefits and claims
Scheduled medical appointments for members
Made sure all call inquiries were closed in a timely manner and routed to the appropriate departments
Spoke with other insurance companies regarding eligibility and coordination of benefits.
Reviewed claims to ensure that they were correctly processed
Logged and documented in detail the entirety and nature of each call from members, providers, and other insurance companies
Entered in member and provider information into the systems such as DOB, address, phone number, etc.
Checked and responded to incoming emails that were received from members and providers in a timely manner
Assisted members over the phone with obtaining refunds from providers for services that were overcharged to them.
Assisted members over the phone with assigning primary care providers to them
Assisted members over the phone with locating in-network primary care physicians and hospitals in their local area.
Assisted members over the phone with understanding billing inquiries that were billed to them from providers after services were rendered