Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000,
Professional Summary

Reliable, flexible, and assume a leadership role whenever possible. I am an expert on the concept of Working with Emotional Intelligence and have facilitated trainings to SSA workgroups on this subject in previous offices. This concept improves our daily work environment by better understanding our contributions as employees and how our emotions effect that contribution as our positions are both emotionally and technically taxing, team work and interpersonal skills are imparative. This promotes better communication, improved interpersonal skills, responsibility, innovation, empathy, and leadership both with co-workers and clients. It allows us to learn from eachother and sharpen our skills emotionally, technically, and electronically. Helps us recognize strengths and places where improvement may be necessary; with a goal to improve the overall work environment.

  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions
Work History
Current to Current Claims Technical Expert/Claims Specialist Radiant Logistics, Inc. | Renton, WA,

While I specialize in Title II initial claims, I also have significant knowledge with SSI and voluntarily take full SSI applications. Additionally, I regularly assist the CSRs at the front counter by processing SSI PE inputs, Title II PE inputs, enumeration, payment issues, and claimant inquiries As a CS, I interview claimants in person and by phone. I also process internet applications. I represent SSA by providing professional, concise, and credible service so that my interaction with all claimants is productive and efficient. I am known for my adaptability to any type of situation or change and my ability to teach and lead others. I am also known for having up to date and accurate information and my ability to apply that knowledge to resolve the most complex and difficult issues. My duties include, but were not limited to, the following: • Determine program eligibility in compliance with SSA policies and procedures • Articulate SSA policies and procedures in a clear, concise manner • Conduct thorough research of Social Security, SSI and Medicare programs • Evaluate and document necessary evidence • Create and send letters and emails to claimants regarding additional and necessary information • Serve as a technical resource for other employees in determining eligibility criteria and resolving complex issues for all Titles including T2, T16, and Medicare • Commended for my courteous and accurate service from both claimants and fellow employees • Processing Prisoner Alerts (PUPS) to insure integrity of SSA Programs and accurate payments • Adjudicate claims for Disability, Retirement, Survivor, Medicare, and SSI applications • Award or deny benefits to claimants • Research and determine some of the most complex claim entitlement issues • Combined family maximum/Parisi • Open application claims similar to SDW claims with more than 10 years retroactivity • Triple and quadruple entitlement • Document final decisions in the claims path • Create and send letters to claimants regarding determination and rationale • Execute manual award and denial decisions with complex A101s, EF101s and MACADEs when necessary • Develop, process and adjudicate the most complex Title II initial claim situations • Mentor others in correct processes to identify and adjudicate complex and uncommon issues • Investigate and process full SSI eligibility • Voluntarily process full SSI applications in order to aide office goals and processing time • Determine eligibility factors in significant detail • Compute SSI payments • Process full applications to conserve appointment slots • Evaluating eligibility for other needs based programs including: • Medicare Prescription Drug plan help through MAPS program • SNAP food assistance • Medicaid • Share knowledge in KZ diary processing • Compute accurate benefit amounts • Utilize interactive computation systems in PCOM, ICERS and DISCO • Calculate insured status and benefit payments electronically and manually • Investigate, develop, and correct earnings discrepancies • Evaluate Military Service and Railroad Service to determine effects on Social Security benefits • Use Benefit Calculators to properly project benefit amounts and comparisons for clients so they can make educated decisions on when to begin collecting benefits. • Analyze claimant’s work activity • Identify and analyze records for substantial gainful activity • Analyze self-employment and employee work activity correctly applying 3 tests accurately and communicating in depth and detailed determinations to DDS • Decipher work history and work programs such as subsidy, IRWE and UWA • Document onset determinations for DDS on the SSA-823 • Establish and process work reports and reviews using eWork program • Guide fellow employees on how to analyze work, apply proper policy, and prepare communications for work related issues • Consider appeals and prior filing factors • Render reconsideration decisions • Process withdrawals and abatements • Conduct personal conferences to evaluate evidence and apply SSA policy to render accurate decisions • Render res judicata and collateral estoppel determinations • Assist the public with appeal submission • Educate claimants on appeal rights and provided necessary forms/instructions • Process technical and medical denial appeals • Maintain SSA credibility • Protect personally identifiable information • Improve the quality of SSA by demonstrating integrity and good judgment • Take necessary action to correct payments • Process recovery of overpayments • Determine waiver eligibility and make waiver determinations • Suspend and reinstate benefits • Adjust or terminate benefits • Spread awareness of potential program abuse and fraud • Perform extensive research and in depth interviews to make Anomalous claim determinations • Educate the public on my Social Security enrollment and eServices • Assist management in handling complicated Congressional Inquiries by communicating policy and resolutions to representatives from Congressional offices • Assist management and other employees in diffusing potential PR situations by applying strong technical knowledge and good communication skills • Multiple documented client feedback forms supporting excellent, accurate and informative customer service • Practice workload management and organization • Utilize workload action center (WAC) on a daily basis • Creating lists, using email system, and processing allowances and denials • Monitor and develop 300+ cases at all times • Ability to multi task to handle multiple cases, maintain time sensitive goals, and answer questions for fellow team members on complicated issues • Assist others in their workload management practices • Produce high volume of work and maintain consistent processing time • Demonstrate expertise in fraud prevention • Perform extensive research and in depth interviews to make Anomalous claim determinations both pre and post Adjudicative • Mentor other staff members on proper processing of Anomalous claims and communication with regional office staff if needed • Assist others in e8551 submissions to OIG • Process OIG inquiries regarding possible program fraud. Establish work reviews for investigation of work related issues for claimants on Disability including personal contact interviews and analyzing paperwork. • Mentoring and Office Trainings • Served as a mentor for a class of 5 new hire claims representatives • Evaluating each claim taken by each CS or accuracy • Training each CS on resolving the most complex issues through policy research and correct application of policy • Prepare class lessons and reviews that included policy references and work flows that I created • Served as mentor to T16 CSs doing crossover training to T2 • Served as mentor to Customer Service Representatives (CSR) both new and seasoned • Improved work processes to maintain needed timeframes for PSIs • Answering complicated processing questions • Expert on policy research including new changes and updates • Keep up to date on policy and procedure changes as it relates to this position in order to offer continued help to this work group • Analyze trainees (Both CS and CSRs) progress, performance, and accuracy with ePAD system; sighting appropriate policy references and providing clear constructive feedback on correcting issues and better processes • Demonstrate ability to work as a team. Always making myself available to help where needed • Proposed training needs to management to strengthen proficiency • Facilitated trainings including creating useful step by step handouts, desk guides, PowerPoint presentations, tutorials and workshops for: • In depth CSR related inputs to help CSs adapt to customer service at the front line • In depth Medicare training including basic and complex issues related to parts of Medicare, IRMAA, reinstatements, enrollments and withdrawals, and Extra help programs • LAPR inputs to insure correct payment for Lawful Presence claims • Attorney file inquiries • Trailer Mail processing • Proper steps for VIPr use • 2.8 Earnings inputs • A101 input guide • SGA and Onset determinations • Representative Payee accounting system to correctly process eRPA alerts • Helpful tips on using WAC to better organize and tackle workloads • Ability to adapt and adjust trainings and communications to accommodate a variety of special circumstances • Conducted one on one trainings for hearing impaired employees • Expert on policy research, interpretation, and application. • Evaluate new changes, resolve complex entitlement issues, and direct others on updates and correct application to help become and keep proficient • Known as the “Go To” resource for proper procedures from all units • Approached by management to resolve a variety of issues including sensitive situations, highly technical issues, and trainings • Share policy clarifications with fellow technicians and management, topics include: • M5/M6 technical denials • SSI KZ dairy processing • Protective filing • Fraud prevention • Collateral estoppel and res judicata • 3rd party application processing • Escalating initial claims to the hearing office • Analyzing SGA for both employment and Self-Employment to accurately set onset dates • Demonstrate strong Interpersonal Skills that lend to approachability and constructive interactions with fellow co-workers, management, members of the public, and members of other agencies • Demonstrate initiative by voluntarily participating in additional duties: • Cashier duties • Issuing immediate payments, paying administrative bills, keeping spreadsheets to ensure budget is met for hearing impaired individuals, coordinating a team of cashiers, communicating with corporate to resolve issues that may arise • eServices team to better inform public of our internet services available • Congressional inquiries • Medicare Attainment Leads • KZ diaries • Unassigned 800# Lead Clean up project • Processed over 100 Survivor benefit leads to help office reduce backlogs • CSR duties by rotation and when needed during high traffic days including handling J1 bus traffic • Mentoring and staff training • President of Sunshine office event planning committee • Volunteered to take on extra workloads including PUPS alerts and IRMAA determinations • Volunteered to help assist employees that are out of the office or behind on workloads to catch up workloads to meet processing goals • Volunteered to process complicated cases to help the team meet processing goals • Utilized by management on several occasions to process complicated cases for other team members Reliable, flexible, and assume a leadership role whenever possible. I am an expert on the concept of Working with Emotional Intelligence and have facilitated trainings to SSA workgroups on this subject in previous offices. This concept improves our daily work environment by better understanding our contributions as employees and how our emotions effect that contribution as our positions are both emotionally and technically taxing, team work and interpersonal skills are imparative. This promotes better communication, improved interpersonal skills, responsibility, innovation, empathy, and leadership both with co-workers and clients. It allows us to learn from eachother and sharpen our skills emotionally, technically, and electronically. Helps us recognize strengths and places where improvement may be necessary; with a goal to improve the overall work environment.

Current to Current Customer Service Representative Social Security Administration, SSA | City, STATE,

Provided SSA clients with a full spectrum of available assistance options regarding all programs administered by the Social Security Administration including e-services Video Service Delivery (VSD) options available Interviewed client to determine their needs and Offer explanations, facts, and options so that the client can make an informed decision, or receives a complete answer, explanation, and information to their question or problem. Offer explanations of eligibility under retirement, disability, Medicare and SSI. Furnish information about work provisions and reporting requirements as well as termination events, overpayment, back payments and current pay status inquiries. Provide documentation where possible including brochures, letters, and forms including direction to SSA website to gain access to these items. Completed SSI abbreviated applications, making determinations of eligibility or ineligibility to SSI benefits. Consider all eligibility requirements including nonmedical and all possible exclusions to income and resources before denying claims. Clearly document reason for denials and input system records creating denial notices while always protecting the claimants appeal rights. Developed documents and resolves Title II and XVI overpayments. Determines amount of excess payment and resolves overpayment by recovery, or offering the reconsiderations and waiver process. Documents SSI file and issues appropriate notices. Received requests for waiver of overpayment in Title II and XVI cases, Completes request for waiver and recovery questionnaires and explains the process to the number holder. Accurately process wage inputs from pay stubs for SSI/Title XVI beneficiaries Resolving K6/K7 and B3 diaries related to SSI/Title XVI benefits. Investigated cases where the number holder’s monthly payments have been interrupted, check for outstanding SMI withholding, garnishments, and offsets. Explain processes that can cause payments to stop. Input nonreceipt when necessary and determine if the claimant is a DCN. Explains the nonreceipt process to the number holder so that they understand the process and the timeframes involved. Discuss the option/requirement for direct deposit, the value and safety it adds, and the processes available to add it. Process Critical payments and immediate payments as necessary to take care of dire need situations Followed up on Double Check Negotiation claims through DCN system. Making proper notations on record to identify such beneficiaries. Provided information and advice about retirement options and compute estimated monthly benefits payable a various ages to allow the individual to make informed decisions about retirement. Explain DRCs and parameters around early retirement (wage limits and decrease in benefits) also explain WEP and GPO situations that may apply. Processed withdrawals of applications as requested by beneficiaries Extensive knowledge of the Medicare program including Part A, B, C, and D. Determine enrollment eligibility, and manages enrollment processes. Answer complex questions and address problems and concerns about the process of enrollment for both disabled and aged clients. Explains enrollment periods, General Enrollment (GEP), Special Enrollment (SEP), and Initial Enrollment (IEP). Prepares enrollment paperwork, explain the enrollment process, and enroll in Medicare. Interview claimants and prepare them for appointments or VSD transfer as well as explain automatic enrollment and cancellation options including surcharges and penalties. Provide guidance to customers on the website options, ordering helpful publications like Medicare and You, and part C and D enrollment. Provide information about state buy in rules and initiates action with the states to enroll individuals. Also help clients resolve complicated issues that arise including billing issues, communication issues, IRMAA, and relationship between agencies. Handled routine questions and inputs into POS regarding change of address, direct deposit, Medicare cards, voluntary tax withholding, student benefits, annual work reports, and GPO/WEP Analysis and input of Garnishments from state agencies. Communicate directly with County Agency for accurate input and follow up concerns Processed third party requests for information on claimant records. Use Feebay to process the appropriate billing for services requested. Create CDs and put together records to satisfy those requests Processed remittances for overpayments, third party requests, premium payment and any other issue regarding return of payment to SSA Input attorney documents including Authorized representative forms and Fee agreements in MCS, MSSICS, as well as eview. Creating notices to attorneys when no application has been received or not file exists Processed replacement and new enumeration applications through Social Security Number Application Processing (SSNAP) including follow up SAVE requests, G845 requests, and resolving investigate issues. Processed earnings discrepancies including adding wages, removing wages, and moving wages through EM 2.8 inputs Processed all representative payee issues including new applications to become payee, representative payee accounting forms, follow up on non-cooperative payees through the eRPA system, and develop for payee fraud; making the proper referral to TE. Inputting suspensions as necessary for reasons of return mail and whereabouts unknown Processed death inputs from SSA-721 forms and death certificates. Followed up on the Death Alert System to insure issues cleared. Conduct process of investigating alerts, contacting outside sources including family, internet, funeral homes, representative payees etc. Generating notices from DPS. Utilizing policy to meet the timeframes outlined. Resolved prisoner issues recorded in PUPS system. Including collecting correct conviction and release documentation to insure proper input. Also, getting agreements for overpayment repayment if necessary. Developed and executed fraud procedures for victims of identity theft including: e8551, auto enrollment fraud block, My SSA internet fraud block, complete 5002, noting client record, creating notice to client. Processed MDWs and PCACS alerts timely and accurately Resolved communications and issues initiated from Congressional offices. Analyze issue and client record, current policy, contact beneficiaries as needed, and communicate thorough response to insure resolution Identify emotionally charged situations including benefit frustration/fluctuation, passing of a family member or friend and provide comfort, support, compassion, council, empathy, and options. Knowledge: Understanding of philosophies regarding Social Security and SSI programs. Knowledge of the SSI program and Social Security, and Medicare programs in order to take basic claims and prepare them for the CR appointment and to determine eligibility for the program. Understanding of regulations and laws, policies and procedures that apply to each type of benefit payable that enables response to questions and the ability to resolve complex issues. Knowledge of SSA’s queries and online/offline data systems to determine status, history, payments and status of the number holder account. Knowledge of reports and forms so the Number Holder will be informed as to options and processes. Knowledge of State, Local, Private and Non-Profit assistance programs so that the Number Holder has many options for assistance outside the SSA including Medicaid, housing, food stamps, etc. Knowledge of the Internet and many search engines so that information is easily and quickly available to clients. Able to direct clients to necessary resources including step-by-step navigation where necessary. Utilized tools in place for assistance-PCOM, TSCOG, Policynet, PCACS, MDW, Death alert system, Prisoner alert listing, representative payee Non responder listing, RPS, PUPS, SSNAP, eWork, DCN wizard, eRPA, eRPS, DPS notices, and sound judgement Use of the WAC workload action center system to stay on top of workload and promote organization Knowledge of Medicare programs, all parts A, B, C and D, including enrollment options and how to navigate the website. Skill in communicating both orally and electronically allowing for clear and concise transfer of sensitive information to the Client and SSA offices. Served as a Cashier for the office. Processing immediate payments for team members. Part of the eServices team designed to promote resources available on to clients. Participating in meetings with other team members, offering suggestions on new ways to present these options, and coordinating monthly eServices events. Resource for management and all units in the office to handle, communicate, and resolve complicated issues Consistently going above and beyond to fully develop issues and utilize knowledge to make others, interviews go smoother on referrals. Adjusted to changes made to processes in work when policies change and suggest options for making workloads and processes more effective. For example, suggesting a change in the way we handle attorney files and discs to insure a safe arrival of information. Made adjustments when management identifies need for change in offices processes. Make suggestions to improve workloads. For example written correspondence to management about DACUS timeframes and improved work process for Attorney files. Training: Served as a mentor/trainer for TSRs on detail in the field to the office on detail. Informal mentor to SR new hires. Helping acclimate to schedules, training environment, introductions to staff, and preliminary workload training. Training them on elementary inputs, getting used to SSA systems, and organizing work. Formal mentor for new Service Representative new hires and former Tele-Service Representatives from the TSC. Resource for expertise on helping them through interviews, programs supported by SSA, training on and reviewing inputs, help with desk organization, training on systems available to complete workloads. Providing assistance to resolve issues that are supported by policy. Helping them research to find answers in Policynet and effectively apply those to situations. Facilitated training on Medicare to all staff covering all parts of Medicare, the relationship between SSA and Medicare, IRMAA surcharges, and enrollment periods. Received positive feedback to management regarding clarity and usefulness information. Facilitated a training on Attorney mail. Updating records for pending disability claims. Inputting fee agreements. Satisfying requests for medical files. Facilitated training on Workload Action Center (WAC) to help new SRs organize and execute their workload. This including pulling important workload lists, how to receipt them in, take action, and make responses on the system for easy tracking, working them timely, showing the electronic connection from WAC to other SSA systems to generate notices etc. Facilitated training on using VIPr for new Service Representatives. This included pulling down numbers, posting the correct subject for the client, referring leads to other departments for RZs, initial claims, PE events. Joint facilitated training and workshops on DACUS. Including development actions, timeframes, and detailed cases. Encouraging thinking outside the box and using resources including the internet, mortuaries, and organizational payees to meet policy timeframes and accurate information inputs Facilitated Representative Payee application training for new SSI CR hires and Service Representative new hires. Including proper development of applicant, checking proper documentation, reviewing records, inputting applications, setting up tickles, and opening/closing events. Study policy for good understanding then pass that along through written and verbal correspondence to team regarding important adjustments/changes in policy are made or helpful additions are released. Able to balance these opportunities and complete my workload. Including keeping up with ePAD inputs (reviews) by trainees and guidance for trainees. Also, assisted other mentors in getting ePad inputs cleared for their trainees. Summary: Reliable, flexible, Positive leader. Consistently brought on new responsibilities and learning added workloads. Now serving as a cashier and a member of the newly created eServices team in the Lakewood DO. Operated as valuable team member carrying my workload, supporting co-workers, willing to help wherever needed, clear communication, and resolving issues. Recognize the importance of being at work to insure this is consistant.

Current to Current Sales Manager/Sales Representative Payroll 1 Inc | City, STATE,

Sales Manager 8/2008-8/2009 Lead local sales team and remote reports in additional city-North Carolina. Responsible for all staffing, training, and on going leadership Supervised all sales support operations. Including reception, sales admin Developed ongoing administrative and tracking including expense reporting and ordering Created tracking reports responsible for data analysis Insured adherence to company guidelines and processes Conducted performance reviews. Took an active interest in each employee with one-on-one conversations making sure perfomance goals and employee needs were met. Coaching and counciling where needed Facilitated national sales training including training on sales tracking tools like Lotus Notes, all Microsoft Windows applications, and utilizing internet systems for state, local, and federal agencies for tax purposes Created and implemented a local training for sales representatives including training on government regulations, quote comparisons, and customer education. Supervised and processed employee expenses and reimbursements. Maintained on going records. Coordinated expense approvals and denials with corporate office including the expenses of high ranking managers. Interacted with these managers on account questions and issues. Communication was verbal and written. Insured that all expenses were in compliance with company guidelines and branch budgets Delivered monthly audit reports for expenses and reconciled them with receipts for purchases. Obtained quotes, submitted orders, and resolved issues with vendors for supplies . Lead purpose driven sales mission based on the concept of Emotional Intelligence Motivated sales teams for consistant sales and production with a focus on managing business plans Sales Representative Extensive Interviewing face to face for needs analysis. Responsible to fit the consumer with proper services to achieve goals while still meeting compliance guidelines for employment and taxation (Federal,State, and Local) Excel at collecting business requirements and need analysis matching with business and product solutions Provided quotes for services to companies. Acted as a consultant by advising on business classification options available. Including: • Applying for and collecting all needed documentation including Power of Attorney for tax identification numbers for Federal, State, and Local governments • Helping business owners select the proper benefits package for heatlth insurance, life insurance and commercial insurance • File necessary employer and employee tax returns at the end of the year • Review company audit reports to identify what payroll reports would be needed to support their business. These reports included 401k , expenses, general ledgers, budget reports etc Prospected clients business to business through phone prospecting and foot canvassing Build and nurture client relationships, professional relationships with accountants, CEOs, CFOs, HR directors Establish solid networking relationships with local business professionals, Denver Metro Chamber of Commerce, and Business Networking International (BNI) Generated business relationships through Denver Metro Chamber of Commerce President of Leads group at the Denver Metro Chamber of Commerce One of 8 members on a Marketing Committee designed to promote the leads group program at the Denver Metro Chamber of Commerce. Focused on building a website and event planning Top sales rep in division and second in company

Current to Current Office Manager/Customer and Financial Services Rep State Farm Insurance | City, STATE,

Directly responsible for the accurate completion of applications, collection of required documentation,finalization of all sales, collection of premiums, and daily banking. Augmented and strengthened the client/company relationship and built credibility and confidence in our products and services Conducted detailed health interviews to determine eligibility for health insurance , life insurance short term disability policies, and long term care Interviewed policyholders after auto accidents collecting details, accident documentation, and applying proper coverage Trained several employees in the district on office procedures, sales implementation, and technical/electronic systems used Responsible for sales in four distinct lines of insurance (health, life, property, and casualty) and a catalo of over 80 products including banking and financial services Made cold calls and field visits to new and existing customers, significantly increasing accounts Prospected from existing client leads, leads lists, and face to face/ business to business personal contacts Conducted Insurance Sales seminars at colleges, employment fairs, and anywhere large groups of people could be prospected Serviced a client base of 1600 households making regular contacts and appointments for service reviews;required to follow up on new documentation needed for files related to income of household, health of household, and new items aquired. Often pivoted to other services that may be necissary to protect households Responsible to know all state laws regarding insurance and apply them correctly. Complete 12 hours of continuing education per year to remain in compliance for insurance license

Expected in 08/2008 Associate of Arts | Business Red Rocks Community College, Denver, CO GPA:
  • Colorado Property Insurance License
  • Colorado Casualty Insurance License
  • Colorado Life Insurance License
  • Colorado Health Insurance License

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Resume Overview

School Attended

  • Red Rocks Community College

Job Titles Held:

  • Claims Technical Expert/Claims Specialist
  • Customer Service Representative
  • Sales Manager/Sales Representative
  • Office Manager/Customer and Financial Services Rep


  • Associate of Arts

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