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

Detailed-oriented individual looking to obtain a position that will allow me to utilize my extensive customer service, financial skills and abilities to support the growing needs of a company. Experienced Claim processor successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 5+ years of experience and willingness to take on any challenge.

  • Professional and Friendly demeanor with strong problem solving skills
  • Excels at multi-tasking in fast-paced environment, completing projects within time and handling multiple priorities
  • Ability to follow and comprehend instructions, short correspondence, and memos
  • Proficiency in MS Excel, Word, Outlook, Power Point and data entry
  • Very dependable and willing to shift work duty based on business needs
Work History
10/2020 to Current Collections Representative Marriott Vacations Worldwide | Marco Island, FL,
  • Reviewed collection reports to determine status of collections and amounts of outstanding balances.
  • Used skip tracing resources to locate debtors and updated information in company system.
  • Recorded all information regarding financial status of customers.
  • Used probing techniques to determine debtors' reasons for delinquency.
  • Negotiated to collect balance in full.
  • Resolved challenging situations with friendly but firm strategies.
  • Achieved performance goals on consistent basis.
  • Managed approximately 70 inbound and outbound calls daily
09/2017 to 09/2020 Pharmacy CSR /Claims Processor Northwell Health | Great Neck, NY,
  • Educates customers on benefits, use of plan, formulary, premiums and status of orders, claims or inquiries.
  • Answers incoming calls; assists customers/pharmacies/physicians with orders and reorders, benefit eligibility questions and prescription status inquiries. Escalates drug related calls to appropriate pharmacist.
  • Makes outbound calls on prescriptions with holds on orders and payment issues.
  • May also assist with entering new prescription orders into system.
  • Review and research claims by navigating multiple computer systems and platforms and accurately capturing data/information necessary for processing (e.g. Verify pricing, prior authorizations, applicable benefits, coding
  • Analyze, investigates, and process Medical Claims
  • Adjust Medical Claims
  • Claims processing
  • Price Medical Claims
  • Audit Appeals and Grievance for compliance errors • Medicare and Medicaid Knowledgeable
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
  • Verified claim data correctness in preparation for processing
08/2014 to 09/2017 Legal Assistant L'oreal | San Francisco, CA,
  • Kept cases organized by establishing and organizing files, documenting actions, Inputting information into file database and case management software.
  • Develop cases by maintaining contact with people involved, scheduling depositions, preparing summonses and subpoenas, drafting complaints, preparing/filing discovery requests, preparing responses to opposing counsel/generating status reports.
  • Keep clients informed by maintaining contact/communicating case progress maintaining case costs by verifying outstanding balances with attorney, clients and providers.
  • Enhanced trial proceedings by organizing evidence, preparing exhibits, scheduling witnesses, and ensuring that witnesses are ready when needed.
  • Supports case preparation by preparing case summaries and materials for mediation conferences, preparing pleas, monitoring/obtaining discovery responses and organizing materials for team case review.
  • Managed accounts and client records of clients, observing confidentiality and extreme discretion.
  • Worked alongside attorneys, administrative assistants and fellow legal assistants on complex cases and legal processes.
  • Scheduled appointments, court appearances and depositions for busy criminal and personal injury law firm with 2 attorneys.
08/2013 to 02/2014 Customer Service Representative Fanatics | City, STATE,
  • Receive inbound payment calls including transferred sales leads and calls from current and potential customers.
  • Answer questions about product details, the company, and issues with account for customers.
  • Assist customers with any technical issues experienced with website and escalate any issues to management appropriately.
  • Perform basic account maintenance activities.
  • Provided primary customer support to internal and external customers in fast-paced environment.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Expected in Associate of Arts | LPN Jersey Nursing College, Jacksonville, FL, GPA:
Expected in 05/2006 High School Diploma | Andrew Jackson High School, Jacksonville, FL GPA:

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School Attended

  • Jersey Nursing College
  • Andrew Jackson High School

Job Titles Held:

  • Collections Representative
  • Pharmacy CSR /Claims Processor
  • Legal Assistant
  • Customer Service Representative


  • Associate of Arts
  • High School Diploma

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