Member Services Representative at Personify Health (2025-03 – 2026-06)
- Verified the accuracy of billing statements and documentation prior to distribution to customers.
- Performed high-volume data entry accurately and efficiently using company databases and specialized software systems.
- Adhered to internal policies, procedures, and regulatory requirements related to customer service and healthcare operations.
- Resolved customer inquiries and complaints promptly while maintaining professionalism and a customer-focused approach.
- Maintained accurate records of customer interactions, transactions, and account updates for future reference.
- Monitored incoming emails and responded to customer inquiries within established service-level timeframes. Assisting in over 100 calls per day
- Updated customer accounts to reflect changes in personal information, coverage, preferences, and account status.
- Collaborated with healthcare providers and insurance representatives to verify treatments and support accurate claim processing and payments.
- Calculated refunds, premiums, adjustments, and other financial transactions with a high degree of accuracy.
- Documented claim status updates and account activity using specialized healthcare and claims-management software.
- Skilled in assisting members with Explanation of Benefits (EOB) statements, explaining coverage details, deductibles, copayments, coinsurance, claim statuses, and explanation of benefits
Resolution Specialist at O'Reilly's Auto parts (2023-06 – 2025-01)
Provided professional customer service by assisting customers with questions, orders, product information, and parts availability. Sourced automotive parts based on customer needs, vehicle specifications, and inventory availability. Researched and identified the correct replacement parts to ensure accuracy and compatibility.
Processed customer orders and coordinated with suppliers and internal teams to locate and obtain needed parts. Maintained accurate records of orders, inventory, customer requests, and transactions. Resolved customer concerns promptly while maintaining a professional and helpful attitude.
Assisted with organizing, receiving, and stocking automotive parts to support efficient daily operation
- Liaised between customers and retail buyers to expedite orders, resolve issues, and ensure customer needs were met efficiently.
- Adjusted bills and processed refunds to resolve customer service and billing complaints accurately and promptly.
- Performed accurate data entry related to customer accounts, orders, payments, and transactions.
- Enhanced productivity and customer satisfaction by anticipating customer needs and proactively addressing concerns.
- Monitored order status and communicated updates to customers and internal teams to ensure timely fulfillment.
- Maintained accurate customer records and transaction information while following company policies and procedures.
Intake Verification Authorization Representative at Focus care of Arizona (2020-03 – 2022-11)
Managed patient intake processes, ensuring accurate collection and verification of demographic, insurance, and eligibility information to support proper registration and coverage validation.
- Secured insurance authorizations and precertifications for medical services, procedures, and treatments in accordance with payer requirements.
- Coordinated with insurance carriers to verify benefits, coverage criteria, authorization status, and patient financial responsibility.
- Reviewed clinical documentation and payer guidelines to determine appropriate authorization pathways and ensure timely, compliant submission of requests.
- Monitored authorization workflows, followed up on pending cases, and accurately documented approvals, denials, and status updates within electronic systems.
- Served as a liaison between patients, healthcare providers, and insurance representatives to resolve coverage and authorization-related inquiries and issues.
- Maintained precise and confidential patient records in compliance with healthcare regulations, organizational policies, and privacy standards.
- Managed high-volume intake and authorization requests efficiently to support timely access to care and reduce delays in treatment
Account Resolutions Representative at PNC Bank (2019-04 – 2023-06)
- Managed customer account intake processes, ensuring accurate verification of personal and financial information to support proper account setup and maintenance.
- Resolved account discrepancies, billing issues, and transaction disputes, including fee reversals, chargebacks, and payment corrections in accordance with banking policies.
- Coordinated with internal banking departments, merchants, and external financial institutions to verify account activity, transaction legitimacy, and resolution requirements.
- Reviewed account histories, transaction records, and fraud indicators to determine appropriate resolution paths and ensure compliance with regulatory and institutional guidelines.
- Monitored account resolution queues, followed up on pending cases, and accurately documented adjustments, outcomes, and status updates within banking systems.
- Served as a liaison between customers and banking representatives to address inquiries related to account balances, disputes, and financial concerns.
- Maintained accurate and confidential financial records in compliance with banking regulations, privacy standards, and organizational policies.
- Managed high-volume account resolution requests efficiently to ensure timely case closure and improve overall customer satisfaction. Assisted and accounts receivable accounts payable and assisted and rebate refunds
