Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - - -

Work on behalf of employers to classify employees by [Date benefit coverage began] and [Cordination of Benefits with Medicare and Secondary Insures]. Skillfully collect and analyze data, survey employees and review occupational data to make accurate assessments. Trained in compensation, benefits and organizational structures.

  • Administering benefits
  • Reviewing benefits
  • Benefits verification
  • Optimizing benefit plans
  • Employee benefits management
  • Compensation and benefits
  • Benefits explanation
  • Benefits administrator
  • Benefit explanation
  • Benefits verifications
  • Knowledge of medical benefits
  • Benefits interpretation
  • Benefits documentation
  • Benefits coordination
  • Health plan benefits
  • Compensation/benefits administration
  • Benefits education
  • Plan benefits understanding
  • Benefits programs
  • Compensation and benefits administration
  • Benefit coding and interpretation
07/1989 to 05/2019
Benefit Analyst Arthur J Gallagher & Co. Manhattan, KS,
  • Provided excellent customer service and attention to customers when face-to-face or through phone conversations. Reviewed the medical necessity of inpatient hospitalizations and outpatient visits. Collaborated with physicians, hospitals and insured to determine eligibility of hospital confinement’s.
  • Answered fifty calls per [Day] to answer customer questions.
  • Maintained updated medical coding using ICD-10.
  • Performed essential research to assist doctors and social workers to coordinate inpatient and outpatient length of stay.
  • Collaborated with others to discuss discharge plans.
  • Improved customer satisfaction by finding creative solutions to problems.
  • Recognized by management for providing exceptional customer service.
07/1985 to 06/1989
Front Desk Medical Receptionist Trinity Health Corporation Sioux City, IA,

Answered multi-line phone system and directed callers to requested personnel and departments.

  • Updated group medical records and technical library to support smooth office operations.
  • Compiled physical and digital paperwork to meet business and patient needs, including charts, reports and correspondence.
  • Maximized office efficiency by answering more than 50 incoming calls per day to provide office information and transfer calls to desired personal.
  • Interviewed patients to collect medical information and insurance details.
  • Supported administrative and healthcare staff with skilled clerical assistance such as ordering supplies and organizing office inventories.
  • Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services in busy Podiatrists office with 5 providers.
  • Prepared and sent financial statements to support bookkeeping functions.
  • Set up appointments for physician visits and procedures using calendar software.
  • Informed patients of financial responsibilities prior to rendering services.
  • Observed strict HIPAA guidelines at all times according to company policy.
  • Took messages from patients and promptly relayed to appropriate staff.
  • Pleasantly greeted each patient and offered the desk sheet for easy sign-in.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to-date
  • Processed patient payments and scanned identification and insurance cards.
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
  • Communicated with all partners throughout the practice including physicians, nursing staff, technicians and medical assistants.
  • Handled all office supply ordering including ink cartridges, toner and paper
  • Greeted callers with enthusiasm, answering all phone calls by second ring.
  • Straightened up the waiting room so that it remained neat and organized.
  • Transcription of medical procedures, audio to type written
06/1981 to 05/1985
Claims Processor Hearst Communications Greenville, SC,
  • Built rapport and trust with injured insureds through effective customer service techniques which involved fair and prompt processing of claims.
  • Coordinated benefits with medical insurance plans and Medicare providers.
  • Researched medical claims for validity to resolve discrepancies.
  • Verified claim data correctness in preparation for processing.
  • Identified client service improvement opportunities in collaboration with team leads and managers to resolve problems.
  • Assisted new policyholders with processing claims.
  • Verified policy holder data, including age, contact number and physical address.
  • Achieved results in ambiguous environment with high level of accuracy and attention to detail.
  • Complied with confidentiality regulations in handling customer information.
  • Collaborated with fellow team members to manage large volume of claims.
  • Collaborated closely with other team members to resolve large volume of claims on [Weekly] basis.
  • Earned reputation for good attendance and hard work.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Answered [100] calls per [Day] to answer customer questions.
  • Recognized by management for providing exceptional customer service.
  • Maintained updated [Coding] knowledge through [CPT-10]
  • Improved operations by working with team members and customers to find workable solutions.
  • Improved customer satisfaction by finding creative solutions to problems.
Education and Training
Expected in 06/2015
Associate of Science: Health Sciences
Goodwin University - East Hartford, CT

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Resume Overview

School Attended

  • Goodwin University

Job Titles Held:

  • Benefit Analyst
  • Front Desk Medical Receptionist
  • Claims Processor


  • Associate of Science

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