MELISSA Palmore
Minonk
Summary
Licensed Customer Experience Agent with a robust track record in enhancing service quality and customer satisfaction through effective communication and collaboration. Demonstrates extensive expertise in the insurance and healthcare industries, having successfully managed complex billing processes and streamlined credit review procedures, leading to improved operational efficiency and customer relations. Passionate about driving innovative solutions, and maintaining meticulous records to support regulatory compliance and optimize customer experiences.
Overview
23
23
years of professional experience
Work History
LICENSED CUSTOMER EXPERIENCE AGENT
RLI Insurance Company
Peoria
08.2023 - Current
- Assisted clients in navigating insurance policies and claims processes.
- Resolved customer inquiries through phone, email, and live chat support.
- Collaborated with cross-functional teams to enhance customer service strategies.
- Documented customer interactions in the company's CRM system for accuracy.
- Educated customers on policy benefits and coverage options effectively.
- Managed escalated issues by coordinating with relevant departments for resolution.
- Conducted regular follow-ups with clients to ensure satisfaction with services provided.
- Identified and escalated priority issues to appropriate teams for resolution.
- Guided customers through troubleshooting, navigating company site and using services.
- Managed time efficiently to respond to customer inquiries in a timely manner.
- Resolved customer complaints and issues promptly, ensuring a positive resolution.
PATIENT ACCOUNT ASSOCIATE (BLUECROSS BLUE SHIELDS 3RD PARTY MEDICAL BILLER)
OSF HealthCare
Peoria
04.2021 - 08.2023
- Support administrators and agents, ensuring efficient operations and customer satisfaction.
- Communicate effectively with internal and external teams, enhancing service quality.
- Document customer interactions, ensuring accurate records and streamlined processes.
- Prepare quotes and bind coverage, aligning insurance products with customer needs.
- Collaborate on inquiries, driving solutions and improving customer experience.
- Support management in billing and collections for professional claims in the Revenue Cycle.
- Collaborate with insurance companies and third parties to ensure accurate claim processing.
- Maintain updated patient records for prompt claim submission and payment accuracy.
- Review billing information to assign account balances to correct payors or patients.
- Identify account issues and take corrective actions for resolution.
- Processed complex medical claims and appeals for BlueCross Blue Shield, ensuring accurate reimbursement while maintaining compliance with healthcare regulations.
- Reviewed and validated patient insurance documentation, reducing claim rejection rates through meticulous attention to coding accuracy.
- Resolved billing discrepancies and payment disputes, facilitating timely revenue collection and improved cash flow for healthcare providers.
- Coordinated with healthcare providers and insurance representatives to expedite claim processing and enhance patient satisfaction.
- Maintained comprehensive documentation of billing procedures and insurance requirements, strengthening departmental knowledge base and operational efficiency.
- Streamlined claims processing workflow for BlueCross Blue Shield accounts, enhancing accuracy and reducing processing delays while maintaining regulatory compliance.
- Resolved invoice disputes, improving accounts receivable accuracy and integrity.
- Collected overdue balances, enhancing customer and sales team relationships.
- Collaborated with Account Managers to set credit limits and payment schedules.
- Made independent decisions on accounts, boosting customer relations.
- Ensured quality service by adhering to established procedures and schedules.
- Managed client accounts and maintained accurate records for OSF HealthCare.
- Collaborated with teams to resolve patient inquiries and concerns efficiently.
- Assisted in coordinating services between departments for optimal patient care.
- Documented interactions and updates in the electronic health record system.
- Responded promptly to inquiries from customers regarding payment status or billing questions.
CREDIT CORRESPONDENT
Taylor Communications
Dayton
04.2016 - 04.2021
- Evaluated credit applications and financial documentation to determine creditworthiness, ensuring thorough risk assessment and maintaining portfolio quality.
- Maintained comprehensive records of credit decisions and correspondence, establishing clear audit trails and supporting regulatory compliance.
- Streamlined credit review processes through standardized documentation procedures, leading to improved processing efficiency and customer satisfaction.
- Orchestrated systematic invoice dispute resolution processes, enhancing accounts receivable accuracy and fostering positive client relationships.
MAINTENANCE BILLING ADMINISTRATOR
NCR
Dayton
04.2010 - 03.2016
- Handle customer inquiries on billing and contracts, enhancing client satisfaction.
- Generate accurate prorated invoices, supporting financial operations.
- Process credit requests efficiently, ensuring timely contract adjustments.
- Collaborate on month-end and year-end accounting tasks, improving financial accuracy.
- Communicate with stakeholders to resolve billing issues, boosting operational efficiency.
- Managed comprehensive billing cycles for maintenance contracts, ensuring accurate invoicing and timely revenue collection while maintaining detailed documentation.
- Streamlined maintenance billing procedures through systematic audit protocols, reducing processing delays and improving departmental efficiency.
- Orchestrated accounts reconciliation processes, resolving discrepancies promptly to maintain healthy cash flow and client satisfaction.
- Coordinated with service teams to align maintenance schedules with billing cycles, enhancing operational transparency and customer communication.
CUSTOMER SERVICE /TEAM LEAD
NCR
Dayton
01.2003 - 04.2010
- Assisted in hiring and training for call center, enhancing team efficiency.
- Managed 24/7 employee schedules, ensuring seamless operations.
- Collaborated with support teams to surpass customer expectations.
- Reviewed and updated customer orders for accuracy in tracking system.
- Orchestrated customer service team operations while mentoring new hires, fostering a supportive environment that enhanced team performance and service quality.
- Streamlined complaint resolution processes, reducing response times and improving customer satisfaction through systematic issue tracking and follow-up.
- Developed comprehensive training materials and led skill-building workshops, elevating team capabilities and consistent service standards.
- Implemented systematic issue tracking and resolution protocols, leading to improved response times and enhanced customer satisfaction rates.
Education
ASSOCIATE DEGREE -
Illinois Central College
East Peoria, IL12.2000
Timeline
LICENSED CUSTOMER EXPERIENCE AGENT
RLI Insurance Company
08.2023 - Current
PATIENT ACCOUNT ASSOCIATE (BLUECROSS BLUE SHIELDS 3RD PARTY MEDICAL BILLER)
OSF HealthCare
04.2021 - 08.2023
CREDIT CORRESPONDENT
Taylor Communications
04.2016 - 04.2021
MAINTENANCE BILLING ADMINISTRATOR
NCR
04.2010 - 03.2016
CUSTOMER SERVICE /TEAM LEAD
NCR
01.2003 - 04.2010
ASSOCIATE DEGREE -
Illinois Central College