Customer Service Representative Resume

A quick learner, excellent communicator and problem solver, with an ability to perform well in a multitasking environment
Consistently demonstrates strong work ethics, exceptional negotiation skills and the ability to adapt quickly to changes
High energy and enthusiasm with strong organizational and management skills

Specialty Pharmacy Prior Authorization Technician Carlsbad, CA April 2011 – November 2011
Customer Service Representative

Processed medical office requests for prior authorization on specialty medications for a high volume mail order pharmacy and pharmacy benefit manager.
Performed manual benefit checks to determine appropriate benefits for authorization .
Escalated drug related issues to pharmacists as appropriate.
Provided customer service support for medical offices, pharmacists and members.
Direct phone-based customer interaction to answer and resolve a wide variety of inquiries.
Educated and assisted members with questions regarding benefits, copay information and status of prior authorizations.
Assisted pharmacists on issues related to processing of pharmacy claims. Determine appropriateness of overriding pharmacy claims edits and error messages. Perform edits as needed and appropriate.
Coordinated internal resolution of claims exceptions and other issues

The Helvetica Group Encinitas, Ca 2009 – 2010
Data Analyst/ Assistant Asset Manager

Performed due diligence, including property inspections, completing property condition reports, title research, data and market analysis, and asset evaluation
Coordinated and managed drivers in the field
Assisted in the management of property assets, including property preservation and maintenance, property rehab and improvements, and preparing assets for sale
Contributed to overall effectiveness and continuing improvement of processes, database management and integrity

Fieldstone Mortgage Company Encinitas, Ca 2001- 2007
Senior Account Executive

Originated subprime residential mortgage loans from a network of mortgage brokers, established by penetrating new markets and expanding on existing accounts
Reviewed credit data and underwriting requirements in accordance with company loan policy and procedures, adhered to all regulatory compliance policies; pre-underwrote all loan submissions
Served as company liaison and central point of contact, providing vital information and resolving issues at all levels
Built territory from the ground up, consistently exceeding monthly sales goals by establishing a reputation for reliability, product knowledge and superior customer service

Fieldstone Mortgage Company Encinitas, Ca 2000 – 2001
Inside Sales Account Executive

Cold calling Las Vegas brokers, originating loans, building sales to over $2 million per month
Originated residential loans via direct marketing and telemarketing campaigns. Reviewed credit data and underwriting requirements, tracking loan to completion through processing and funding.

Atr Electronic Medical & Dental Billing Service Encinitas, Ca 1991-1996
Manager

Provided billing service for high volume diagnostic laboratory. Coordinated scheduling of tests. Responsible for insurance verification, authorizations, insurance follow-up, and collections. Prepared insurance claims, patient statements, and monthly management reports. Negotiated settlement of liens. Tracked insurance claims to full payment.

Jenny Craig Weight Loss Centre, Encinitas, Ca 1989-1991
Manager

Directed all operational and sales activities for corporate owned weight loss center generating $1.5 million in annual sales. Implemented and coordinated sales and promotional programs including lead generation, telemarketing and follow-up. Managed all personnel including hiring, training, supervising, motivating, and evaluating. Responsible for purchasing and inventory control, accounting and bookkeeping, customer service and problem solving. Participated in company leadership and management training programs.
Consistently placed among Top 3 producers, Awarded the Achievement, Performance Awards

University Of California, San Diego – Bachelor Of Arts In History