1. DEBORAH M ALSTON
820 Blazingwood Drive
Greensboro, NC 27406
d.alston.36@hotmail.com
(336) 617-0050
PROFILE
Highly personable Customer Service Professional with over ten years of experience in Customer Service and support with
recognized strength in account maintenance, problem solving. I have ten years in claims.
I have working knowledge of balance sheet and income statements.
HIGHLIGHTS OF QUALIFICATONS & ACCOMPLISHMENTS
• Talent for identifying customer needs and presenting appropriate company product and service offering
• Ability to train and motivate a team of employees
• Demonstrated ability to gain customer trust and provider exceptional follow-up, leading to increased
• Repeat and referral business
• Expertise in resolving escalated customer service issues
• Proficient with Microsoft Office System (including Microsoft Word, Microsoft Excel, Microsoft
• PowerPoint, Microsoft Access, and Microsoft Outlook). Lotus Notes
• Strong individual with strong leadership capabilities
• Working knowledge of balance sheet and income statements
PROFESSIONAL EXPERIENCE
LAPCORP (April 2011 – present)
Greensboro, NC
Healthcare Billing Specialist works in health care centers like all other health care professionals, but the scope of work is related
to generating bills for reimbursement in instances when patients have health insurance.
• Enter patient insurance and address into the AS400 system
• Call providers to get patient insurance and any other missing information needed for billing purposes.
• Fax requisition over to provider for proof of services.
• Enter information into the system from the requisitions.
KMART (August 2008 – October 2009)
Kissimmee, FL
Customer Services Supervisor responsible to assist in the supervision of cashiers and participate in maintaining outstanding
customer service as per Company standards. Processing sales quickly and efficiently, cash register operations, and safeguarding
Company assets.
• Assist in training all cashiers in all front-end policies and procedures, including training of new cashiers and cross
training of other associates.
• Assist in communicating all information to cashiers regarding special promotions and sale items.
• Expedite front lines, direct flow of customers, and ensure that each customer receives outstanding customer service by
providing a friendly environment, which includes greeting and acknowledging every customer, maintaining solid
product knowledge and all other aspects of customer service.
• Authorize and ensure validity of customer returns, exchanges, check authorizations, and voids.
• Oversee compliance of cashiers with established Company policies and standards, such as safekeeping of Company
funds and property, personnel practices, security, sales and record-keeping procedures.
• Provide orderly maintenance of front-end equipment and supplies.

2. • Accurately and efficiently ring up sales and accurately maintain all cash and media at the registers.
• Communicate customer requests to management.
• Enter all media from register into tally program.
• Maintain orderly appearance of register area and supplies stocked.
• Any other tasks as assigned from time to time by any manager.
Severn Trent Services (TOHO Water Authority) (April, 2008- October, 2009)
Kissimmee, FL
Customer Services responsible to initiate process and communicate customer request for service and information. Answer
incoming telephone and conduct general accounting, clerical duties.
• Talk with customers by phone or in person, receives and processes orders for new accounts, turn ons, discontinuance,
or change in services
• Process credit refunds, collections, transfer balances, delinquent accounts, two day notices, corrected bill and reverse
payments
• Maintains all reports and registers
• Determines charges for services requested, prepares change of address records, and issues discontinuance orders.
• Initiates and reviews status of services orders requested by customers.
• Preparation of general financial reports and work orders
• Post payments
• Process refund checks
UNITED HEALTHCARE (Oct, 2000 – June, 2008)
Greensboro, North Carolina
Inquiry Resolution Unit Representative –Sr. Claims Adjuster (Jan, 2006-June, 2008)
• The Pharmacy Resolution Unit Analyst ensures the Pharmacy Resolution Unit team meets or exceeds establish service
standards.
• The incumbent investigates issues, appeals, and facilitates the adjustment of pharmacy claims as necessary
• Provide feedback to the members and providers
• Working in a team environment, the incumbent participates in the daily operations of the team and assists other team
members.
• Manage issues, appeals; facilitate the adjustment of pharmacy claims, medical claims, radiology claim as necessary and
Medicare and Medicaid claims.
• Handle written inquiries; Perform related research; Resolve all escalated members’ and provider issues
• Address members and provider appeals, investigate, make determinations and respond to member’s and provider’s
• Identify the source and scope of errors, and facilitate necessary adjustment.
• Serve as liaison; Enter medical, dental, and pharmacy claims into the system
Customer Care/Adjustment Specialist – RRE (2004-2006)
Responsible for answering member’s calls and processing claims.
• Efficiently navigate claim-processing systems to complete claims and simple adjustments from an immediate customer
request.
• Handle repeat callers, escalated issues and highly complex customer inquiries.
• Provide callbacks to customers within the appropriate timeframes (24 hours) and communicate to the call the status,
resolution and closure of the issue.
• Thoroughly research all open ORS inquiries based on established thresholds, responsible for any follow-up work
needed for resolving and closing issues.
• Manager ORS and Claims inventory when not speaking directly to customer.
• Maintain accurate documentation on each ORS worked utilizing PCORS or Host ORS system.
• Serve as first point of escalation for both internal and external business partners and other customers.
• Achieve quality and efficiency objectives and Maintain proficiency in all technical applications
• Provide excellent quality service to our consumers/providers and ensure that there is full understanding of the plan

3. benefits and Enter medical, dental, and pharmacy claims into the system.
Customer Response Group (2002 to 2004)
Investigate and resolve first and second level escalated issues. I serve as kind of a liaison to the Account Manager, Network
Management, Brokers, Internal and External customer.
• Resolve claim issues; Complete Special Projects, and CRT projects
• Researching escalated claims, Medicare and Medicaid claims and benefit issues
• Working with hospital, physician, account managers, brokers and member to get resolution to escalated
• Assist in updating member’s benefits and files; Reading providers’ contracts
• Keying escalated and normal claims in the system; Support sales representative
• Enter medical, dental, and pharmacy claims into the system.
Customer Services Rep (2000 to 2002)
Responsible for answering incoming calls from physicians or customer while ensuring a high service of maximizing productivity.
• Resolve basic types of customer service and physician inquiries and benefits questions
• Eligibility and order customer materials
• Identifying customers needs and presenting appropriate company needs
• Enter medical, dental, and pharmacy claims into the system.
EDUCATION AND TRAINING
Guilford Technical Community College (Working toward my Associate degree in Medical Office Administration)
REFERENCES
Will provide upon request