Zireya Simmons
Pass Christian,MS
Summary
Adept at managing high-volume dispute resolutions with a 95% success rate at Global Payments, I excel in complaint resolution and data entry. My background in tech support and healthcare enhances my ability to offer exceptional customer service, underscored by strong communication skills and a proficiency in Microsoft Office suite.
Overview
5
5
years of professional experience
Work History
FEP MPDP Representative
ContinuumGlobal
11.2024 - Current
- Assist members with placing refill orders for medications
- Run test claims for potential or current medications for accurate pricing
- Contact pharmacies to ensure correct billing of medications
- Follow HIPPA guidelines for verification
- Submit prior authorization request to doctor's office
- Submit new rx request to doctor's office
- Assist with web and app navigation
- Assist providers with questions about rx for members
Tech Support
Everise
07.2024 - 09.2024
- Provide assistance with electronics, such as phones, tablets, computers, printers, etc
- Provide walkthrough steps on how to solve any technical issues with devices
- Provided technical support problems through email, telephone, and hands-on support.
- Researched and implemented methods to improve support processes and provide better services to customers.
Disputes Specialist
Global Payments
01.2024 - 06.2024
- Managed dispute resolution process for high- volume accounts, handling an average of 250 cases per month with a 95% resolution rate
- Analyzed transaction data to identify fraudulent activity
- Collaborated with internal teams to streamline efficiency
- Attended regular training sessions to improve team productivity
- Assist with completion of lost, stolen, or block and transfer tasks on compromised accounts
- Build card replacement orders and complete shipping tasks
Heathcare Representative
Conduent
08.2022 - 02.2023
- Communicated regularly with patients about billing issues, appointments, and procedures.
- Obtained patient information to properly record and document demographics and medical histories.
- Assisted patients in understanding how insurance coverage works and calculated copays.
- Assisted patients with obtaining and rescheduling appointments.
- Followed up with doctors and nurses to obtain necessary information to complete patients' records.
- Managed incoming phone calls to resolve patient inquiries and refer calls to appropriate departments.
Tech Support
SYKES
06.2020 - 07.2022
- Effectively communicate and assist customers with their questions and any troubleshooting responsibilities with their equipment
- Update/input and new information for customers
- Successfully explain how to use equipment
- Assist with billing questions
- Schedule resolution callbacks
- Deescalate any unsatisfied costumer issues with empathy and concern
Education
Medical Billing And Coding Associate - Medical Billing And Coding
Ultimate Medical Academy
Clearwater, FL06-2026
Associate of Arts - Business
Pearl River Community College
Poplarville, MS05-2022
High School Diploma -
Bay High School
Bay St. Louis, MS 05-2020
Skills
- Data entry specialist
- Scheduling
- Complaint resolution
- Account updating
- Inbound and outbound calling
- Product education
- 50 WPM typist
- Certified in Word, Powerpoint, and Excel
- Project Planning
- Excellent Communication Skills
- Active Listening
- Documentation and Record Keeping
Timeline
FEP MPDP Representative
ContinuumGlobal
11.2024 - Current
Tech Support
Everise
07.2024 - 09.2024
Disputes Specialist
Global Payments
01.2024 - 06.2024
Heathcare Representative
Conduent
08.2022 - 02.2023
Tech Support
SYKES
06.2020 - 07.2022
Medical Billing And Coding Associate - Medical Billing And Coding
Ultimate Medical Academy
Associate of Arts - Business
Pearl River Community College
High School Diploma -
Bay High School
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