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Melanie Randels


Inbound, outbound calls & web based customer service proficient computer skills in Microsoft Office Programs Insurance knowledge Multitasking Excellent written/verbal communication & critical thinking skills Team morale building skills as well as a keen attention to detail Interviewing assistance, human resource and recruiting knowledge.


11/09-Present Express-Scripts Inc St. Louis, MO DOD Claims Specialist (previous titles: Data Entry, Prior Authorization, Eligibility Clerk) Handle inbound and outbound patient and physician calls regarding pharmacy and insurance benefits. Processed reimbursement for military claims for DOD. Appointed leadership tasks such as assisting with interviews, helping new hires as a Subject Matter expert teaching them their role and facilitating team meetings. Maintain productivity standards to meet deadlines with state and company regulations regarding acceptance, denials and enrollment procedures of patients into not for profit medical services and programs. Displayed the ability to stay true to the Express Way Values of integrity, collaboration, mutual respect, and alignment which led to two promotions and several cross-training opportunities. 11/08-11/09 Matthews Medical Services St. Louis, MO Customer Service/ Web Support/ Auditor Provided proficient, courteous customer care, in a high volume office environment to customers inquiring via email and telephone, through multiple websites daily. Drafted credit summaries, faxed and generated invoices. Cross trained as a switchboard operator, bookstore cashier, editor, and web support specialist for books and medical supply purchases. 02/07-Per Diem Barnes Jewish Hospital St. Louis, MO Cashier/ Catering Support Finalized monetary, check, and credit transactions effectively using POS systems. Worked as a team to ensure efficiency and success in a high volume food service atmosphere. Became educated on the carious dietary needs of each patient in order to serve them safely and with care


2012-Present 2011-2012

Fontbonne University Corporate Communications

St. Louis, MO (Massage Therapy Associate 08) St. Louis,MO

ALIVE (domestic violence hotline)

Volunteer Opportunity