Livecareer-Resume
Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Dependable Insurance industry worker equipped for fast-paced work and changing daily needs. Serves customers effectively with attention to detail and hardworking approach. Seeks out opportunities to go beyond basics, improve processes, and increase customer satisfaction. With nearly 20 years experience, looking to further a career into a Supervisor or Trainer position. Authorized to work in the US for any employer.

Skills
  • Team Leadership
  • Goals and Performance
  • Decision-Making Abilities
  • Conflict Resolution
  • Processes and Procedures
  • Search Engine Optimization
  • Training and mentoring
  • Group and individual instruction
  • Remote Learning
  • Materials Preparation
  • Project implementation
  • Customer service and assistance
  • Client Engagement
  • Organization and Time management
  • Computer proficiency
Work History
Account Specialist, 01/2018 - Current
Experian Ca 90501, CA,
  • Collecting debts from Insurance carriers with use of appeal either verbal or written.
  • Pulling and reviewing medical records, claims. and EOBs from EHR's or carrier portals.
  • Work 20-25 accounts per day.
  • Assist in hiring process, review resumes, interview applicants, and determine if applicant is good candidate for position.
  • Training and shadowing new hires.
  • Assist Supervisor preparing spreadsheets for team, providing weekly collections for client, preparing client meeting data and providing information for meeting.
  • Point person for project preparing accounts for review.
  • Developed and maintained courteous and effective working relationships.
  • Identified issues, analyzed information and provided solutions to problems.
  • Successfully maintain clean, valid driver's license and access to reliable transportation.
  • Used Microsoft Word and other software tools to create documents and other communications
  • Participated in team-building activities to enhance working relationships
  • Developed team communications and information for meetings
  • Used coordination and planning skills to achieve results according to schedule
  • Carried out day-day-day duties accurately and efficiently
  • Developed and maintained courteous and effective working relationships
  • Prepared variety of different written communications, reports and documents to ensure smooth operations
Administrator III, 12/2013 - 11/2017
Presbyterian Medical Services Albuquerque, NM,
  • Prepared subject issues for meetings with client.
  • Prepare synopses of appeal cases for Federal Hearing Officer.
  • Using provided information to determine most appropriate step for appeal to move.
  • Working with other members of team to break down more difficult appeals and resolve best action to be taken.
  • Quality review , training and shadowing.
  • Worker 50 accounts per day.
  • Team Leadership.
  • Used Microsoft Word and other software tools to create documents and other communications
  • Supervised work of contracted employees to keep on task for timely completion
  • Identified issues, analyzed information and provided solutions to problems
  • Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
  • Worked flexible hours; night, weekend, and holiday shifts
  • Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
  • Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting
  • Used critical thinking to break down problems, evaluate solutions and make decisions
Claims Pre-processor, 10/2001 - 12/2013
Claims Processor TMG HEALTH City, STATE,
  • Data Entry
  • Entered up 10 500 accounts per day.
  • Claims adjudication.
  • Received and reviewed incoming documents and materials
  • Researched and resolved discrepancies to maintain accuracy
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
  • Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Recommended products to customers, thoroughly explaining details
  • Evaluated account and service histories to identify trends, using data to mitigate future issues
  • Responded to customer requests for products, services and company information
  • Answered constant flow of customer calls with minimal wait times
  • Consulted with outside parties to resolve discrepancies and create effective solutions
  • Offered advice and assistance to customers, paying attention to special needs or wants
Education
Associate: Healthcare Management, Expected in 2018
-
Penn Foster College - Scranton, PA
GPA:
HIGH SCHOOL DIPLOMA: , Expected in 1991
-
Wyoming Valley West High School - Plymouth, PA
GPA:

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Resume Overview

School Attended

  • Penn Foster College
  • Wyoming Valley West High School

Job Titles Held:

  • Account Specialist
  • Administrator III
  • Claims Pre-processor

Degrees

  • Associate
  • HIGH SCHOOL DIPLOMA

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