Federal Employee Program Claims Specialist Ii Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Offering 8 years of consecutive experience, with an extensive background in claims, customer service and administrative support. I have exceptional oral and written communication skills, and I am well versed in proactively identifying priorities and accurately interpreting and applying regulations, policies and procedures. Passionate about high-quality work and exceeding company goals.

  • Proficient in the use of all Microsoft applications to include Word, Excel, PowerPoint, Access, and standalone network environments such as TPX and Streamline.
  • Type 70 words per minute.
  • Administrative support
  • Billing
  • Closing
  • Insurance claims
  • Medical terminology
  • Advanced oral and written communication skills
  • Healthcare Common Procedures Coding System (HCPCS) and
  • ICD-9 Coding
  • ICD-10 Coding
Work History
Federal Employee Program Claims Specialist II , 01/2014 to 10/2020
Te Connectivity LtdMountain View, PA,
  • Coded and processed over 4000 claims monthly for payment ensuring all information is accurate and supplied before eligible payments are made.
  • Researched and analyzed claim and coordination of benefit issues.
  • Analyzed compiled data regarding pending claims and make recommendations to superiors for improving processing.
  • Proficient usage of various claims processing software, such as QCare, Claims Assist, WGS, and FEP Direct.
  • Assisted in training other claims associates on proper handling and evaluation of professional and facility claims.
  • Assisted with assigned escalated projects to resolve major facility provider claims issues.
Customer Service Specialist II, 12/2009 to 11/2013
Lineage LogisticsPlano, TX,
  • Operated in high-volume call center environment to provide skilled assistance to more than 150 customers each day. Assisted customers via inbound calls inquiring supplemental health insurance policies; provide current and accurate information, knowledge of medical terminology, state insurance and tax regulations.
  • Provided support to customers regarding billing, existing products, and services.
  • Advised customers, brokers, and medical providers with information on customer policies according to HIPPA regulations.
  • Surpassed performance goals by approaching all interactions with resourcefulness, organization and customer-centric solutions.
  • Increased efficiency and team productivity by promoting adherence to operational best practices and company policies.
  • Retained accounts by addressing potential cancellations and offering catered solutions to maintain account status.
Administrative Clerk, 09/2007 to 03/2009
The Money TreeCity, STATE,
  • Assisted branch manager in office growth through maintenance and development of existing and new customer base.
  • Created welcoming environment for customers by greeting and assisting, as well as quickly responding to customer inquiries and needs. Met monthly sales goals and solicited customers.
  • Answered questions and advised customers of information regarding loans and transactions.
  • Sorted, opened and routed incoming correspondence and deliveries to help senior leaders respond quickly to business and customer requirements.
  • Produced highly accurate internal and external letters and memoranda.
  • Answered multi-line phone system efficiently and transferred callers to appropriate department or staff member.
  • Helped office manager in identifying training needs and providing ongoing training opportunities as needed. Interviewed loan applicants to obtain personal and financial data for applications and closing documents while verifying and examining information for accuracy.
  • Collected on loan accounts, advise debtors of alternative options regarding past due accounts, balanced checkbooks, prepared and typed loan applications, closing documents, collateral documents, forms, and checks or money orders using computer.
Receptionist/Recruiter Assistant, 02/2006 to 12/2007
Staffing ConnectionsCity, STATE,
  • Processed an influx of applicants daily, pre-screened applicants and scheduled interviews with appropriate team members. Assisted branch recruiter with job placement inquiries and reviewing applications for posted temporary to permanent positions.
  • Delivered friendly assistance with new hires throughout interviewing and hiring process, and when placing initial hiring interest calls for inquiries.
  • Kept applicant information confidential, communicated effectively with a diverse background of applicants, contacted applicants for appropriate assignments, and administered drug screens effectively.
  • Performed various administrative functions such as preparing and organizing various reports of applicant data, handling multi-line phones, filing paperwork, sorting mail, copying, faxing, and updating information on branch website.
Certificate Life & Health Insurance: , Expected in
Columbus Technical College - Columbus,
Bachelor of Science: Business Administration, Expected in
Columbus State University - Columbus,

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Resume Overview

School Attended
  • Columbus Technical College
  • Columbus State University
Job Titles Held:
  • Federal Employee Program Claims Specialist II
  • Customer Service Specialist II
  • Administrative Clerk
  • Receptionist/Recruiter Assistant
  • Certificate Life & Health Insurance
  • Bachelor of Science

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