Ebare' Gordon
North Chicago
Summary
Customer Service Professional with extensive experience in call center environments. Delivered exceptional service through effective problem-solving and diplomatic communication, successfully addressing customer concerns and defusing escalated situations. Motivated to embrace new challenges while maintaining a strong work ethic and adaptability.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Referral Specialist
Carelon Medical Benefits Management
Deerfield
06.2018 - Current
- Initiates and manages clinical referrals for pre-authorization.
- Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
- Coordinated with provider offices to ensure timely completion of referrals prior to scheduled appointments.
- Reviews referrals for completeness and follows up for additional information if necessary.
- Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, etc.) following established process and procedures.
- Responds to inbound calls initiating exam requests following established processes. Meets quality and production standards.
- Contacts physician offices as needed to obtain demographic information or related data.
- Enters referrals, documents communications and actions in system.
Specialty Customer Care
CVS Caremark
Buffalo Grove
09.2016 - 06.2018
- Worked closely with pharmacists and used medication input software to safely and accurately dispense medication
- Appropriately resolved customer issues, complaints and questions
- Communicated with all customers and staff in a pleasant and professional manner
- Promptly referred all doctors' calls and customers' medical questions to the pharmacist on duty
Collections Representative
Armor Systems Corp
Zion
08.2015 - 09.2016
- Provided support in negotiating repayment plans with customers facing financial difficulties.
- Directed inbound calls in phone queues, enhancing overall call flow.
- Negotiated credit extensions to assist customers in paying overdue accounts.
- Supported negotiation of repayment plans for customers facing financial difficulties, facilitating resolution of overdue accounts.
- Provided accurate and appropriate information in response to customer inquiries.
- Managed irate customers effectively, contributing to performance target achievement.
- Handled irate customers smoothly to achieve performance targets.
- Followed up on promises made by customers regarding payments or settlements.
- Properly directed inbound calls in phone queues to improve call flow.
Certified Nursing Assistant
HCR Manorcare
Libertyville
05.2014 - 08.2015
- Observed and documented patient status and reported patient complaints to the case manager.
- Prepared patient rooms prior to their arrival.
- Planned, prepared and served meals and snacks according to prescribed diets.
- Positioned residents for comfort and to prevent skin pressure problems
- Assisted with transferring residents in and out of wheelchairs and adaptive equipment..
Customer Service
Walmart
Waukegan
07.2010 - 02.2014
- Enhanced customer confidence by actively listening to concerns and providing tailored feedback.
- Built customer confidence by actively listening to their concerns and giving appropriate feedback.
- Processed all sales transactions accurately and in a timely fashion.
- Resolved customer inquiries and complaints in person and via phone to ensure satisfaction.
Education
High School Diploma -
Warren Township High School
Gurnee, ILSkills
- Referral management
- Pre-authorization processing
- Claims processing
- Insurance verification
- Attention to detail
- Precertification processes
- CPT coding
- Clinical documentation
- Data entry
- Accurate documentation
- Healthcare systems
- Medical terminology
- Pre-authorizations
- Claim forms
- Co-payment collection
- Attention to detail
- Problem solving
- Organizational skills
- Prioritizing tasks
- Effective communication
- Conflict resolution
- Healthcare industry
- Co-payment collection
Certification
- CPR Certification
- Certified Nursing Assistant Certificate
Timeline
Referral Specialist
Carelon Medical Benefits Management
06.2018 - Current
Specialty Customer Care
CVS Caremark
09.2016 - 06.2018
Collections Representative
Armor Systems Corp
08.2015 - 09.2016
Certified Nursing Assistant
HCR Manorcare
05.2014 - 08.2015
Customer Service
Walmart
07.2010 - 02.2014
High School Diploma -
Warren Township High School