SUMMARY:

To secure a position as Customer Services Supervisor or Manager that is challenging and that will benefit from my experience and promote high standards of professional conduct and work performance to guarantee advancement..

SKILLS:

Promotes high quality customer services. Ability to work independently and as a team player. Progressive development of excellent interpersonal and communication skills. Dedicated and self - motivated, flexible, initiative, proven reliability and determination. Sufficient in Microsoft office works, outlook, word, excel, PowerPoint, access, tcs, cti, medical terminology, cpt and icd 9 codes, PBM, POS, Medicare and Medicaid Insurance, workers comp and management experience, Supply Management, Informing Others, Tracking Budget Expenses, Staffing, Managing Processes, Supervision, Developing Standards, Managing 1-25 employees, Promoting Process Improvement, Inventory Control, Reporting Skills

WORK EXPERIENCE:

Confidential

Customer Care Coordinator

Responsibilities:

• Contact referring physician’s offices, members and imaging providers via telephone to communicate radiology authorization approvals, denials and appeals information, while maintaining confidentiality, Contact referring physician’s offices via telephone to verify authorization information, obtain additional clinical information or facilitate a peer to peer consultation between ordering physician and a Confidential Physician Reviewer.
• Receive verification requests from rendering providers via telephone with regard to existing authorization requests; utilizing the Informa-HM system, verify registration information and log verification data in the database, Processes withdrawals and other case status changes as needed, electronically attach incoming clinical faxes to authorization requests for radiology studies. Collect after hours voice messages, research questions, triage case to the appropriate team and/or return calls as needed, handle general information requests related to an already existing authorization via telephone and facsimile from providers, patients and various external sources, while offering the highest NIA quality service.
• Receive verification requests from rendering providers via telephone with regard to existing authorization requests; utilizing the Informa-HM system, verify registration information and log verification data in the database.

Confidential

Store Manager

Responsibilities:

• Directs and supervises 12 associates, engaged in sales, inventory-taking, reconciling cash receipts, or in performing services for customers.
• Ensures weekly schedules are prepared to provide proper floor coverage within fiscal guidelines; manage attendance, reviews time sheets and other payroll documentation for accuracy and submits as appropriate. Promotes customer service by ensuring associates are greeting and assisting customers;
• Manages the general operations of the store ensuring that the store is in working order and adequately supplied to ensure safe and efficient operations.
• Ensures compliance with all applicable laws, loss prevention policies, operating procedures and controls; conducts associate training as needed to reinforce proper controls.
• Recruits, hires, and develops store associates; prepares and conducts all performance appraisals and evaluations; interprets Key Performance Indicator reports and delivers coaching as needed. motivate employees to accomplish department and company goals, HR policies (attendance, dress code, cell phone, etc.) Other duties as assigned/required.

Confidential

Supervisor/Assistant Manager

Responsibilities:

• Directs and supervises 12 associates engaged in sales, inventory-taking, reconciling cash receipts, or in performing services for customers.
• Ensures weekly schedules are prepared to provide proper floor coverage within fiscal guidelines; reviews time sheets and other payroll documentation for accuracy and submits as appropriate.
• Promotes customer service by ensuring associates are greeting and assisting customers; responds to customer inquiries and complaints in a professional and timely manner.
• Models sales expectations by utilizing various techniques and communicating product knowledge to the customer; recommends merchandise selections or helps to locate or obtain merchandise based on customer needs and desires. Maintains a visually appealing store, ensuring proper housekeeping, visual merchandising, and organization are kept to the highest standard.
• Trains associates on visual merchandising techniques to ensure store is maintained at all times.
• Monitors associate sales activities and productivity; acknowledges and communicates performance to associates; motivates and trains associates to achieve full potential.
• Performs all financial activities effectively and in accordance with policy including cash handling and reporting, price changes, and merchandise handling; ensures all register transactions are completed accurately and in accordance with policy.
• Prepares and oversees physical inventories, ensuring proper accounting of receipts and outflows of merchandise.
• Manages the general operations of the store ensuring that the store is in working order and adequately supplied to ensure safe and efficient operations.
• Ensures compliance with all applicable laws, loss prevention policies, operating procedures and controls; conducts associate training as needed to reinforce proper controls.
• Recruits, hires, and develops store associates; prepares and conducts all performance appraisals and evaluations; interprets Key Performance Indicator reports and delivers coaching as needed. Other duties as assigned/required.

Confidential

Prior Authorization Coordinator

Responsibilities:

• Review request from doctors and pharmacist to determine whether medication coverage authorization can be given by screening and reviewing request based on benefits plan, eligibility and client specifics and clinical criteria.
• Review appeals letters; communicate the approval or denial by calling or faxing the response to the originator of the request.
• Handled inbound, outbound and workers compensation calls and emails. Educate members on their prescription benefits and setup their mail order service. Coach and mentor new agents coming out of new hire training class. Assist with special projects that are assigned to me from upper management.
• Handle inbound patient, physician and client calls in relation to order status, shipment, and eligibility while maintaining productivity standards and performance guarantees where applicable.
• Work with other operational department to research and resolve mail order and eligibility issues.