LiveCareer-Resume

dental insurance csr resume example with 11+ years of experience

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

Organized and efficient Data Entry Specialist with 3 years of experience in data organization, proofreading and word processing. Consistent in meeting project deadlines by prioritizing and communicating with teammates. Personable team player with exceptional customer service abilities. Fast learner and committed to continuous, self-directed learning.

Skills
  • Strong Communicator
  • Excellent Interpersonal Skills
  • Ability to work independently
  • Works effectively with diverse populations
  • Motivated Team Player
  • Team builder
  • Attentive listener
  • Organized and Efficient
  • Exceptional multi-tasker
  • Writing and verbal communication
  • Relationship building
  • Detailed-oriented
Work History
09/2021 to Current Dental Insurance CSR Hillsborough County Sheriff's Office | Tampa, FL,
  • Reviewed prior-authorizations, claims, and expedited urgent follow-up requests.
  • Assured timely verification of insurance eligibility and benefits prior to patient procedures or appointments.
  • Evaluated uploaded documents to locate needed information to support medical necessity.
  • Monitored database updates and verified for correctness.
  • Completed data entry task with accuracy and efficiency.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Assisted customers with filing an appeal, complaint, grievance, provider changes, and finding dental specialist.
07/2017 to 02/2020 Child Protective Investigator American Family Insurance | Tucson, AZ,
  • Inbound/Outbound calls.
  • Contacts, interviews, and obtains valuable information (over-the-phone or in-person) from medical professionals, school personnel, and law enforcement.
  • Conduct Investigations out in field, according to intake, investigation, evaluation, and referral by
    friends and family of children as appropriate.
  • Assessed home for any hazardous materials and take photos of each room as needed according to age of child.
  • Prepares reports on investigation, documented data, and completed accurate updates to case records.
  • Proactively managed high caseload with documented plans of action to ensure timely, appropriate, and thorough case closures.
  • Established and maintained rapport with child's counselor, therapists, school teachers, doctors,
    witnesses, and probation officers to establish individual treatment plans outlining goals of treatment.
  • Provided community service information and referrals to children and their families to enhance child's welfare.
  • Devised and implemented safety plans for children suspected as victims of abuse and neglect.
  • Develop appropriate, risk alleged incidents of child abuse for Family Team Meeting for status
    determination.
  • Collaborated on program operations with DFPS Advisory Committee, including offering feedback from participants and improvement recommendations.
  • Prepared necessary letters for final ruling upon case findings within investigation.
06/2013 to 07/2017 Texas Works Advisor II Caseworker Texas Health And Human Services Commission | City, STATE,
  • Determined eligibility and enrollment of clients in (SNAP,TANF, CHIP, Medicaid, Medicare
    Savings Programs).
  • Interview clients, document current information gathered, determine benefits, and verify case data.
  • Verified scheduled appointments, canceled if necessary and rescheduled due to incorrect data.
  • Updated client demographics daily to maintain accuracy in state portal.
  • Maintained and ensured all established workflow/procedures and departmental goals are followed.
  • Screened applications/applicants for expedited services on government assistance (Medicaid, SNAP,TANF, CHIP).
  • Maintained records, files, or accountability tracking logs to include filing, retrieving, or purging.
  • Explained program benefits, requirements, rights of appeal, and fair hearing to clients.
  • Established priorities according to relative importance and deadlines.
  • Participated in team huddles and monthly team meetings to discuss clients needs, and implement any new changes sent from state office; also adjusting flow of work to meet team and client needs.
  • Actively participate in special assignments, programs, or improvement initiatives with successful outcomes.
  • Managed multiple tasks in fast-paced environment.
01/2009 to 05/2013 Customer Service Sales Representative Innovative Consultants Inc (Call Center) | City, STATE,
  • Resolved concerns with products or services to help with retention and drive sales.
  • Addressed escalated customer service issues sent from sales and service teams to save customer
    relationships.
  • Maintained accurate and current customer account data with manual forms processing and digital
    information updates.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Documented and detailed calls and complaints using call center's CRM database.
  • Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
  • Responded to customer inquiries, offering excellent support and tailored recommendations to address
    needs.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Exceeded call monitoring expectations through accurate reporting and processing.
  • Met or exceeded sales, customer service and loyalty program standards.
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards.
  • Met all customer call guidelines including service levels, handle time and productivity.
Education
Expected in 05/2015 to to Master of Science | Healthcare Administration Texas Southern University, Houston, TX GPA:
GPA: 3.9
Expected in 05/2012 to to Bachelor of Science | Healthcare Administration, Public Health Texas Southern University, Houston, TX GPA:
GPA: 3.89
Expected in 05/2004 to to High School Diploma | Skyline High School, Dallas, TX GPA:

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Resume Overview

School Attended

  • Texas Southern University
  • Texas Southern University
  • Skyline High School

Job Titles Held:

  • Dental Insurance CSR
  • Child Protective Investigator
  • Texas Works Advisor II Caseworker
  • Customer Service Sales Representative

Degrees

  • Master of Science
  • Bachelor of Science
  • High School Diploma

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