Benefits Verification Specialist Remote resume example with 10+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - - -

Personable and dedicated Customer Service Representative with extensive experience in Customer Support Center industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.

  • Verbal and Written Communication
  • Open Enrollment
  • Highly Skilled in CRM Software, SAP, Citrix systems, etc
  • Active Listening
  • Computer Skills
  • Efficient and Detail-Oriented
  • Courteous with Strong Service Mindset
  • Data Entry
  • Multitasking and Prioritization
  • Calm and Professional Under Pressure
  • Issue and Complaint Resolution
  • Creative Problem Solving
  • POS Systems and Ordering Platforms
  • Transaction Processing
  • Upbeat and Positive Personality
  • Microsoft Office Expertise
  • Providing Customer Support
  • Technical Troubleshooting
  • Inbound and Outbound Call Management
  • Call Documentation Skills
  • Critical Thinking
  • Supervision & Leadership
  • Friendly, Positive Attitude
  • Organizational Skills
  • Relationship Building
  • Customer Data Confidentiality
  • Customer Account Management
09/2022 to 03/2023
Benefits Verification Specialist (Remote) TalentBridge, Lash Group City, STATE,
  • Checked accuracy and completeness of benefits applications and documents.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Updated patient and insurance data and input changes into company computer system.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Navigated through multiple online systems to obtain documentation.
  • Accessed third-party insurance databases to identify coverage of benefits.
  • Entered data in EMR database to record payer, authorization requirements and coverage limitations.
  • Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
  • Performed verification of Medicare coverage.
  • Coordinated benefits processing, including enrollments, terminations and claims.
  • Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
  • Maintained strong call control and quickly worked through scripts to address problems.
  • Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Supported hospital and clinic operations using customer service skills and detailed system knowledge.
06/2019 to 09/2022
Customer Service Operations Walmart City, STATE,
  • Identified root cause solutions contact issues by asking probing questions to identify and understand the issue; documented customer and associate concerns and feedback; researching issues; identified and communicated data trends to multiple departments and implemented resolutions
  • Responded to escalated contacts; researched issues as necessary; and provided resolution
  • Resolved complex contact issues for the store, associates, and high-impact customers by researching issues and resolution options, determining appropriate resolution
  • Provided information to customers and associates, utilizing program quality guidelines and program resources
  • Authorized customer compensation to achieve customer satisfaction with issue resolution
  • Followed up with customers on issues; implemented resolutions; communicating final decisions and resolutions to customers
  • Complied with company policies, procedures, and standards of ethics and integrity by implementing related action plans
  • Completed work assignments and priorities by using policies, data, and resources, collaborating with managers, co-workers, and customers.
  • Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
  • Appraised inventory levels on frequent basis, ordering new merchandise to keep quantities well-stocked.
01/2015 to 01/2018
Customer Service Executive II TalentBridgeCox Automotive, Autotrader City, STATE,
  • Answered questions from customers by phone and email, offering company details and policy information as requested.
  • Provided consultative information to Dealers, Private sellers, and the auctions as they do business with Auto trader
  • Developed deep and wide relationships with Sales, Field Locations, Corporate Partners, National Account teams to solidify Auto trader Digital offerings as the most preferred digital automotive marketplace for buyers and sellers
  • Partnered with all parties informed of the status of open issues and worked closely with escalation partners to identify, document, and monitor all exceptions to the standard processes to create a list of best practices
  • Problem Resolution was a major part of maintaining relationships with existing customers, including problem solving
  • Consulted with dealers and educated them about Auto trader's product and service
  • Provided responsive, timely telephone, chat, and email support
  • At a minimum all calls had to be returned before the close of business on the same day as “first call resolution”
  • Personally acted as the single, point-of-contact for customer's issues from identification through resolution as often as possible
  • Explained benefits and advantages of different product and service offerings to customers.
  • Developed cooperative relationship with other team members-built relationship not only with customers but the internal team members as well.
05/2011 to 12/2014
Customer Escalations Representative (Remote) Enterprise Holdings Inc., Rent-A-Car City, STATE,
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Completed in-depth research for numerous technical issues and helped establish procedures to prevent repetitive problems.
  • Drove customer escalations to resolution by engaging directly with clients.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Adjusted bills and refunded money to resolve customers' service or billing complaints.
  • Strengthened customer retention by offering discount options.
  • Referred unresolved customer grievances to designated departments for further investigation.
  • Prepared and evaluated CRM reports to identify problems and areas for improvement.
  • Handled 80-100 incoming back-to-back calls daily to book quality reservations for our three brands worldwide
  • Efficiently guided conversations and applied sales techniques to convert calls into reservations
  • Communicated effectively with all customers to meet company and client goals for orders and service and reviewed and resolved escalation issues
  • Provided accurate price quotes and provided detailed information on rentals and rental locations
  • Provided exceptional customer service and collected required information from the customer on every call per established criteria
  • Demonstrated and maintained professional oral and written communication with customers, coworkers, and other company staff
  • Communicated information considered unsatisfactory by customers in a tactful manner
  • Offered alternatives and options to overcome customer objections
  • Consistently met established performance and quality standards
  • Located and interpreted complex information from multiple databases
Education and Training
Expected in 05/2005
Bachelor of Science: Hospitality Administration And Management
SUNY Buffalo State College - Buffalo, NY
  • Customer Service Professional Certificate - 2022
  • Leadership Training - 2005
  • Hospitality Management Certificate, Walt Disney World - 2004

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Resume Overview

School Attended

  • SUNY Buffalo State College

Job Titles Held:

  • Benefits Verification Specialist (Remote)
  • Customer Service Operations
  • Customer Service Executive II
  • Customer Escalations Representative (Remote)


  • Bachelor of Science

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