Lisa Morlan
Pasadena
Summary
Results-driven professional with a solid track record in customer service and claims processing within healthcare and financial services. Achievements include reducing customer complaints by 53% and maintaining a 98% first-contact resolution rate, demonstrating a commitment to operational efficiency and enhanced customer satisfaction.
Overview
17
17
years of professional experience
Work History
Claims Specialist
CVS Health
01.2023 - 05.2026
- Manage a high daily volume of medical claims, ensuring timely and accurate processing.
- Evaluate claims for accuracy and completeness; research and resolve discrepancies or missing data.
- Followed up on denied claims to achieve timely resolution and safeguard patient payment outcomes.
- Verified patient insurance coverage and benefits to ensure accurate claims processing.
- Review provider coding information to verify accuracy and ensure services are reported correctly.
- Apply administrative guidelines to resolve coverage questions and support compliant claims adjudication.
Customer Service Representative
Wayfair
03.2023 - 04.2024
- Assist customers with account inquiries via phone and email, consistently achieving a 98% first-contact resolution rate.
- Handled high volumes of inbound and outbound calls, ensuring professional and efficient customer interactions.
- Triage customer complaints and escalations, fast-tracking critical issues for swift resolution.
- Resolved billing and service disputes, driving a 75% increase in post-interaction customer satisfaction scores.
- Reduced customer complaints by 53% through targeted problem-solving strategies and staff training initiatives.
- Maintained quality control policies and procedures, enhancing overall customer experience.
- Trained new team members on policies and procedures, streamlining onboarding process.
Customer Service Agent
Discover Financial Services
03.2021 - 09.2023
- Delivered world-class member experiences by resolving inquiries and processing financial transactions with precision.
- Created travel notifications and maintained Debit, Credit, and ATM card accounts to ensure secure and seamless member transactions.
- Reviewed daily home banking messages and provided timely, accurate solutions to member concerns.
- Processed PIN requests and managed plastic card orders and reorders for all card product types to ensure timely access for members.
- Generated monthly identity theft and fraud watch reports to enhance risk monitoring and protect member accounts.
- Maintained current product details and protocols to ensure contract and disclosure compliance.
- Completed and processed write-off and close-out packages to ensure accuracy of account entries and applied credits.
Customer Service Representative III
Maryland Department of Transportation (MDOT)
01.2009 - 12.2022
- Managed high inbound call volume with minimal wait times and consistently high first-contact resolution rates.
- Investigated non-compliance with motor vehicle laws and regulations to enhance customer service outcomes.
- Enforced insurance and vehicle emissions inspection laws to ensure compliance with state guidelines and improve public safety.
- Hired and trained staff to provide exceptional service, fostering a motivated team environment.
Prior Authorization Specialist
Express Scripts
01.2021 - 08.2022
- Contacted insurance carriers to obtain prior authorizations for tests, procedures, and treatments.
- Accurately entered all patient data related to claims and prior authorizations into clinical systems.
- Collected and recorded patient insurance and demographic information for use by medical personnel.
- Monitored referral submissions throughout prior authorization facilitation process to ensure timely processing.
- Drafted and sent denial letters outlining reasons for denial and available appeal options to support patient understanding.
- Confirmed provider eligibility and ensured compliance with authorization requirements to maintain operational standards.
Education
High School Diploma -
Glen Burnie High School
Glen Burnie, MD06-2007
Associate of Applied Science - Radiology
Anne Arundel Community College
Skills
- Claims Management
- Claims Adjudication
- Claims Processing Systems
- Claims Data Review
- Claims Compliance Review
- Medical Billing & Coding
- ICD-10
- Insurance Coverage Verification
- Quality Assurance
- Coding accuracy
- Documentation Review
- Claims processing
- Claims Resolution Strategies
- Insurance coverage
- EMR Systems
- Process Improvement
- Recordkeeping
- Schedule Coordination
- Microsoft Office Suite
- Typing: 70 WPM
- Call Center Operations
- Verbal communication
- Professional Telephone Etiquette
- Customer Relations
- Cross-Functional Collaboration
- Problem resolution
- Quality assurance
Timeline
Customer Service Representative
Wayfair
03.2023 - 04.2024
Claims Specialist
CVS Health
01.2023 - 05.2026
Customer Service Agent
Discover Financial Services
03.2021 - 09.2023
Prior Authorization Specialist
Express Scripts
01.2021 - 08.2022
Customer Service Representative III
Maryland Department of Transportation (MDOT)
01.2009 - 12.2022
High School Diploma -
Glen Burnie High School
Associate of Applied Science - Radiology
Anne Arundel Community College