customer servce claims advocate ii resume example with 9+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Excellent Customer Service Advocate driven to exceed and facilitate. Works independently, with demonstrated consistency.

Self-directed professional dedicated to promoting loyalty and retention through proactive communication, effective problem-solving and personably follow-through. Utilizes company expertise and my critical thinking skills to manage concerns independently with willingness to escalate critical issues. Offering my many skills while allowing room to learn new skills.

  • Efficient and Detail-Oriented
  • Call Documentation
  • Productivity Standards
  • Calm and Professional Under Pressure
  • Excellent Attention to Detail
  • Online Chat
  • Knowledge and processing of government claims
  • Administrative and Office Support
  • Billing Adjustments and Refunds
  • Inbound and Outbound Calling
  • Proactive Self-Starter
  • Team-Oriented and Cooperative
  • Livechat Messaging
  • Building Customer Trust and Loyalty
  • Inquiry Research
  • Issue and Complaint Resolution
Work History
Customer Servce Claims Advocate II, 08/2019 - 07/2022
Shutterfly, Inc. Wayne, NJ,
  • Researched and resolved account and service problems with friendly, knowledgeable support.
  • Documented customer concerns and inquiry resolutions in internal computer system.
  • Listened to customers in actively to assess issues and provide accurate information.
  • Accessed multiple databases to investigate customer questions and concerns.
  • Served as point of contact for customers and worked to resolve rejected claims and explain the reasons for the denials. On some occasions repr[cess or adjusts for payments.
  • Examined reports, accounts and evidence to determine integrity and accuracy of information.
  • Followed up with customers on unresolved issues.
  • Proposed settlements for uncomplicated issues to resolve claims.
  • Processed and recorded new policies and claims.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Communicated effectively with staff members of operations, finance and clinical departments.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Met customer call guidelines for service levels, handle time and productivity.
Enviromental Service Technican, 09/2017 - 06/2019
McLeod Regional Medical Center City, STATE,
  • Wore necessary personal protective equipment to minimize risks from hazardous materials, biohazards and other harmful substances.
  • Cleaned and disinfected patient exam rooms, surgery suites and common areas to promote sanitary treatment and services environment.
  • Emptied trash cans and recycling bins to promote clean, sanitary environment and reduce odors and debris.
  • Utilized chemicals and cleaning equipment to meet facility's predetermined sanitation and cleanliness quality standards.
  • Interacted with hospital staff, patients and families to demonstrate good customer service techniques.
  • Practiced established infection control methods to reduce risks to patients, families and medical staff.
  • Moved chairs, desks and beds around rooms to clean behind and underneath furniture.
  • Slid beds, sofas and other furniture aside to wipe down baseboards and remove dust and dirt from hard-to-reach areas.
  • Complied with applicable standards during cleaning of specialty areas such as labs, surgery suites and labor and delivery rooms to maintain exceptional level of cleanliness.
  • Restocked room supplies such as facial tissues for personal touch with every job.
Shift Manager, 05/2012 - 04/2017
Hardee's Restaurant City, STATE,
  • Trained and mentored new employees to maximize team performance.
  • Supervised employees and oversaw quality compliance with company standards for food and services.
  • Kept employees operating productively and working on task to meet business and customer needs.
  • Coached crew members to optimize performance and motivate toward more efficient work.
  • Exercised composure under pressure and in escalated customer service scenarios.
  • Excelled in every store position and regularly backed up front-line staff.
  • Worked closely with team members to schedule breaks and shifts to meet state regulations.
  • Consistently exhibited calm demeanor during periods of high volume or unusual events to keep store operating smoothly and set positive example for shift team.
  • Adhered to company standards and compliance requirements for operations and cleanliness of areas.
  • Tracked receipts, employee hours and inventory movements.
  • Managed schedules, accepted time off requests and found coverage for short shifts.
  • Trained back-up associates and led crew members in managing operations of storefront.
Secretarial Science: Secretarial Studies And Office Administration, Expected in 03/1995
Burdett Business - Boston, Ma,
Status -

Certification in Secretarial Science

: Business Administration, Expected in 08/1984
Claflin University - Orangeburg, SC
Status -
Diploma: , Expected in 09/1980
West Roxbury High - West Roxbury, MA
Status -

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Resume Overview

School Attended

  • Burdett Business
  • Claflin University
  • West Roxbury High

Job Titles Held:

  • Customer Servce Claims Advocate II
  • Enviromental Service Technican
  • Shift Manager


  • Secretarial Science
  • Diploma

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