KAYLA RANDEN
DAYTON
Summary
Experienced Customer Service Representative who is committed to providing customer care by identifying needs and providing solutions, creating positive experiences, and building rapport.
Overview
16
16
years of professional experience
Work History
PBX OPERATOR
BLUECROSS BLUESHIELD OF TENNESSEE
05.2024 - Current
- Answered incoming calls, using active listening and probing skills to direct callers to correct department or individual based on their needs, in accordance with established procedures
- Obtained and documented necessary information to properly route calls
- Managed high call volumes in a timely and efficient manner
- Managed multiple tasks simultaneously while maintaining a high level of accuracy
- Reported telephone line issues and outages for prompt repairs
ASSISTANT OFFICE MANAGER
ASPEN DENTAL
11.2016 - 04.2024
- Scheduled and confirmed patient appointments
- Greeted and checked in patients in a welcoming manner
- Coordinated patient flow by setting up efficient schedules for multiple providers
- Gathered and entered patient information into electronic charting system
- Verified insurance eligibility and coverage
- Informed patients of their financial obligation
- Collected and posted co-payments and patient financial responsibilities
- Investigated and resolved patient financial disputes
- Reviewed claims per Explanation of Benefits for accuracy on posted insurance payments and in-network discounts
- Submitted inquiry tickets to dispute claims to meet provider and member needs in a timely manner
- Coordinated treatment and financial arrangements
- Pre-qualified and applied patients for third-party financing
- Checked and responded to voicemails in a timely manner
- Answered multi-call lines and directed to appropriate personnel
- Performed clerical duties such as copying, faxing, and filing
- Balanced nightly deposits and credit card processing
CUSTOMER SERVICE ADVOCATE
BLUECROSS BLUESHIELD OF TENNESSEE
06.2022 - 09.2022
- Conducted educational calls while advising members of available benefits
- Offered assistance in locating providers in member’s network
- Researched medical claims for possibility of adjustment in coordination with policy guidelines
- Verified eligibility and/or lapse in coverage
- Utilized multiple software programs for research
- Used mail out procedures to send documents such as ID cards, provider network status, Explanation of Benefits, and medical claim forms
- Updated Coordination of Benefits and educated members how it affects processing of claims in a timely manner
- Communicated over multiple channels such as Microsoft Teams, e-mail, and phone
- Connected misrouted calls to proper department
- Assisted members with calling providers regarding scheduling, claims not on file, and billing statements
- Ensured all communication with members was clearly documented
ASSISTANT MANAGER
SHOPRITE
02.2009 - 11.2016
- Trained, developed, and managed staff
- Maintained, reviewed and resolved differences between accounting information and cash drawers
- Processed POS transactions, including checks, cash, and credit card purchases or refunds
- Recorded daily and weekly sales for grocery, meat, and produce departments to balance accounting reports
- Customer service and conflict resolution
- Ensured proper vendor and warehouse receiving
- Reconciled vendor invoices
- Ordering and inventory control
- Kept sales floor and stockroom clean and organized
- Reviewed time cards for missed punches and vacation before submitting to payroll
- Planned and prepared work schedules
- Minimized losses with proper stock rotation
- Assisted customers with locating items
- Answered phones in a professional manner
Education
DIPLOMA -
BRILLARE BEAUTY INSTITUTE
08.2011
HIGH SCHOOL DIPLOMA -
RHEA COUNTY HIGH SCHOOL
05.2008
Skills
- Managing customer inquiries and resolving timely
- Communicating through channels such as phone, e-mail, and Microsoft Teams
- Proficient working within a team or as an individual
- Appointment scheduling and confirmation
- Ability to hold multiple jobs while maintaining high performance standards
- Well-developed communication skills
- Skilled in thoroughly documenting communication with patient or customer
- Dedication to customer satisfaction
Timeline
PBX OPERATOR
BLUECROSS BLUESHIELD OF TENNESSEE
05.2024 - Current
CUSTOMER SERVICE ADVOCATE
BLUECROSS BLUESHIELD OF TENNESSEE
06.2022 - 09.2022
ASSISTANT OFFICE MANAGER
ASPEN DENTAL
11.2016 - 04.2024
ASSISTANT MANAGER
SHOPRITE
02.2009 - 11.2016
DIPLOMA -
BRILLARE BEAUTY INSTITUTE
HIGH SCHOOL DIPLOMA -
RHEA COUNTY HIGH SCHOOL
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