Darius Kimbrough
Columbus
Summary
Results-oriented Customer Service and Healthcare Support Professional with five years in high-volume call center environments. Skilled in care coordination, insurance support, and issue resolution, consistently meeting productivity and quality benchmarks. Maintained over 95% documentation accuracy and achieved high customer satisfaction scores across remote and office settings. Expertise includes Microsoft Office Suite, electronic healthcare systems, HIPAA compliance, and data entry.
Overview
12
12
years of professional experience
Work History
Care Connector
AmeriHealth Caritas
05.2022 - Current
- Coordinated appointment scheduling, transportation logistics, prescription assistance, and access to community resources, driving improvements in member satisfaction scores.
- Coordinated appointment scheduling, transportation logistics, prescription assistance, and access to community resources, improving member satisfaction scores.
- Streamlined communication between providers, pharmacies, case managers, and members for prompt resolution of healthcare-related issues.
- Enhanced care management operations by identifying care gaps, escalating urgent clinical issues, and supporting follow-up outreach for preventive care and chronic condition management.
- Maintained comprehensive documentation of member interactions while adhering to HIPAA regulations in electronic healthcare systems and care management platforms.
- Streamlined communication among providers, pharmacies, case managers, and members to resolve healthcare-related issues promptly.
Healthcare Customer Service Representative II
BlueCross BlueShield of Georgia
09.2016 - 04.2022
- Managed 70–100 inbound member and provider calls daily concerning benefits eligibility, claims status, prior authorizations, billing inquiries, and policy coverage.
- Achieved customer satisfaction and quality assurance ratings surpassing company benchmarks while ensuring compliance with stringent HIPAA and regulatory requirements.
- Handled member inquiries promptly through thorough claims research, insurance verification, and coordination with providers and internal teams.
- Managed processing of policy updates related to demographic changes and service requests, ensuring high precision and thoroughness.
- Guided members through details of healthcare plans, copays, deductibles, referrals, and available wellness resources to strengthen member comprehension and retention.
- Met performance benchmarks associated with average handle time (AHT), first-call resolution (FCR), attendance, productivity, and call quality standards.
- Utilized multiple systems simultaneously including CRM software, claims databases, and Microsoft Office Suite in a fast-paced call center environment.
Assistant Coordinator
Road America
05.2014 - 08.2016
- Directed high-volume inbound calls from stranded motorists needing roadside assistance, towing, lockout, battery delivery, and emergency services.
- Coordinated service dispatches for tow truck operators, locksmiths, and roadside vendors while ensuring timely response and customer satisfaction.
- Supported 70–100 customers each day in dynamic call center setting while demonstrating professionalism amidst high-pressure conditions.
- Utilized GPS mapping systems in conjunction with internal dispatch software to reliably pinpoint customer locations and deploy service providers efficiently.
- Maintained call quality, attendance, average handle time (AHT), and documentation accuracy metrics in accordance with company standards.
- De-escalated upset or distressed customers by providing clear communication, empathy, and real-time service updates during roadside emergencies.
- Recorded all customer interactions, dispatched updates, and resolved service issues accurately within company databases while ensuring adherence to policy and compliance procedures.
Education
Associate of Arts - Business
University of Phoenix
05.2001 -
High School Diploma -
Harris County High School
Skills
Appointment scheduling
Service excellence
Communication skills
Financial processing expertise
Insurance verification
HIPAA compliance
Insurance billing
Intake assessment
EMR data entry
Eligibility determination
Attention to detail
Organizational filing systems
Timeline
Care Connector
AmeriHealth Caritas
05.2022 - Current
Healthcare Customer Service Representative II
BlueCross BlueShield of Georgia
09.2016 - 04.2022
Assistant Coordinator
Road America
05.2014 - 08.2016
Associate of Arts - Business
University of Phoenix
05.2001 -
High School Diploma -
Harris County High School