Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
Professional Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Core Qualifications
  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions
Customer Service Representative, 06/2014 to 03/2015
Select Express & LogisticsSeattle, WA,

•Identified how to best assist beneficiary callers with our appeal services

•Maintained effective working relationships with both external and internal customers

•Utilized internal quality control tools to assess individual work and team processes

•Lead trainer for all new hires

Quality of Care Representative, 03/2015 to Current
Banner HealthGlendale, AZ,

•Triaged all Quality of Care calls to determine the best resolution

•Gave referrals for external agencies outside of our quality of care scope

•Completed all immediate advocacy complaints within CMS guidelines

•Provided status updates to both Medicare Providers and beneficiaries

•Prepared all quality of care complaint and consent forms for review

Product Client Service Representative, 07/2011 to 09/2012
Oneworld Community Health CentersOmaha, NE,

•Conducted second tier business-specific customer support to IOCR Advantage Clients

•Answered client inquiries regarding incorrect claim and billing processing

•Gathered detailed root cause analysis from operator processing errors

•Interacted with service partners from the Health Care Imaging team to ensure accurate and timely client feedback and resolution

•Trained all employees on newly implemented processing procedures

Reconciliation/Enrollment Specialist, 11/2010 to 03/2011
Akumin Inc. J UsfSaint Petersburg, FL,
Temp Position Reviewed current and new members Medicare and Medicaid enrollment information for completeness. Evaluated various systems affiliated with members information to ensure accuracy of insurance plans per departmental guidelines. Modified errors per management and system upload required in order for accurate processing. Trained incoming temps on all systems per management. Also assisted Team Lead as well as Department Manager on various projects. Claire 2
Clerical Assistant, 02/XXX7 to 09/XXX9
Human GoodSouth San Francisco, CA,
Provided a complete range of clerical support services for 30+ employees. Entered Care Manager notes for tracking of client billing in companies PEP (Positive Education Program) Client Information System. Retrieved files for auditors of The Board of Mental Health by supplying information to assist in resolving insurance and billing issues. Gathered clients demographics and other related paperwork for various agencies such as Social Security Disability, Rehabilitation clinics, Courts and Lawyers per approved request.
Credentialing Support Specialist, 01/XXX7 to 02/XXX7
Lightroom StudiosWest Milford, NJ,
Temp Position Assisted both the Credentialing Manager and physicians by ensuring that all Medicaid and state licensing information was current in company's SyMed system. Updated and processed physicians information in a timely and accurate manner to insure state licensing and provider enrollment. Submitted Medicaid applications, correspondence, and other related materials to physicians for completeness and signatures via fed-ex.
Medical Records Representative, 02/XXX6 to 04/XXX6
MetroHealth Medical CenterCity, STATE,
Prepared and processed medical and shot records for patients and outside agencies such as Lawyers, Social Security Disability, and other medical facilities. Generated payment invoices for all outgoing medical records as well as tracked all records received into and sent out of the department in company's EPIC (Electronic Patient Information patient tracking system. Performed a variety of clerical duties including record maintenance, faxing, scanning, photocopying, and front desk support for physicians and nurses.
Medical Records Technician, 07/XXX5 to 10/XXX5
Menorah Park Center For Senior LivingCity, STATE,
Managed daily patient census information of all incoming and outgoing patients and updated their charts accordingly. Assisted in collecting patient demographics and insurance information for all new and returning residents as well as assigning medical record numbers. Ensured that residents ADLs (Activities of Daily Living) and care plans from MDS (Minimum Data Sheet) form were correctly entered and updated weekly into companies MDS system. Prepared inactive patient charts for storage and/or auditing purposes.
Data Entry Operator, 03/XXX2 to 07/XXX5
Medical Mutual Of OhioCity, STATE,
Reviewed medical claims for accuracy as well as corrected errors, and entering missing data. Maintained control of claims processed by properly following batch control procedures. Performed daily production, procedural, and quality quota of 97% for all processed claims. Informed team leader of unusual situations affecting productivity and efficiency of data flow. Worked with team members meeting and exceeding production deadlines. Assisted in other duties as assigned.
Associate of Science: Healthcare Administration, Expected in
Cuyahoga Community College - ,
Cuyahoga Community College Indiana Wesleyan University Associate of Science Bachelor of Science Major: Healthcare Administration Expected: Fall 2015 Expected: Fall 2016
Professional Affiliations
Billing, Clients, Customer Service, Receptionist, Retail Sales, Claims, Data Entry, Entry Operator, Medical Claims, Quota, Clerical, Disability, Security, Clerical Support, Mental Health, Answering, Benefits, Customer Support, Eobs, Hci, Human Computer Interaction, Liaison, Operations, Optical, Production Environment, Production Schedule, Quality Assurance, Root Cause Analysis, Associate, Healthcare, Customer Service Representative, Quality Control, Imaging, Staffing, Medicaid, Medical Records, Medicare, Reconciliation, Team Lead, Auditing, Epic, Faxing, Front Desk, Invoices, Maintenance, Medical Facilities, Scanning, Correspondence

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Resume Overview

School Attended

  • Cuyahoga Community College

Job Titles Held:

  • Customer Service Representative
  • Quality of Care Representative
  • Product Client Service Representative
  • Reconciliation/Enrollment Specialist
  • Clerical Assistant
  • Credentialing Support Specialist
  • Medical Records Representative
  • Medical Records Technician
  • Data Entry Operator


  • Associate of Science

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