LiveCareer-Resume

Health Assistant Customer Service resume example with 12+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Knowledgeable and dedicated customer service professional with extensive 13 years of customer service experience in Retail, Auto/ health Insurance industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing business. My goal is to work in an environment which encourages me to succeed and grow professionally where I can utilize my skills and knowledge appropriately. To utilize my skills and provide a professional service to customers by applying and honing my knowledge and working in a challenging and motivating working environment. To also enhance my professional skills, capabilities and knowledge in an organization which recognizes the value of hard work and trusts me with responsibilities and challenges.

Skills
  • Team direction
  • Staff training
  • Promotional planning
  • Decision Making
  • Policy Knowledge
  • Customer service oriented
  • Employee mentoring
  • Organizational skills
  • Multitasking
  • Strong communication skills
  • Inventory monitoring
  • Organizing and prioritizing
  • Cash register operation
  • Time management
  • Budgeting and cost control
  • Schedule management
  • Problem solving
  • Data Entry and Maintenance
  • Customer Retention Strategies
  • Call Documentation
  • Upbeat and Positive Personality
  • Issue and Complaint Resolution
  • Efficient and Detail-Oriented
  • Building Customer Trust and Loyalty
  • Understanding Customer Needs
  • Proactive Self-Starter
  • Team-Oriented and Cooperative
  • Call Volume and Quality Metrics
  • Calm and Professional Under Pressure
  • Live chat
  • Documentation review
  • Medical terminology
Experience
Health Assistant Customer Service, 09/2022 to 12/2022
Equality HealthHouston, TX,
  • Maintained strict confidentiality of protected health Information to comply with HIPAA regulations
  • Obtained proper authorization and identification prior to release of confidential medical records
  • Verified and updated changes in patient, physician, or insurance to maintain proper billing
  • Updated and maintained database with accurate customer information and timely data entry
  • Developed and maintained working knowledge of internal policies, procedures and services to appropriately address customer issues
  • Responded to telephone inquiries and complaints following standard operating procedures
  • Delivered personalized customer service relating to questions and promptly resolved basic problems on customer accounts
  • Complied with corporate and regulatory policies regarding information confidentiality and privacy
  • Investigated and researched issues to determine root causes and appropriate resolution methods
  • Gave accurate and appropriate information to answer questions, troubleshoot issues and resolve complaints
  • Navigated multiple computer systems and applications and utilized search tools to find information
  • Provided members with policy coverage information for in network providers and coverage procedures
  • Contacted providers offices when needed to provide correct codes for filing claims
  • Operated the live chat
Employee Engagement Coordinator, 06/2022 to 09/2022
Advanced Drainage SystemsOlympia, WA,
  • Interact with employees via phone and chat to help resolve questions they have regarding benefits and/or payroll
  • Assist employees in accessing and navigating benefits system
  • Educate employees on system enhancements related to benefits
  • Provide explanation of benefits option based on client summary plan descriptions
  • Assists with life event changes for newly eligible employees, marriages/births, and related dependent verifications
  • Establish and maintain effective relationships with client benefits and HR managers
  • Correspond with benefit carriers to validate benefit coverage
  • Participate in system testing in preparation for Open Enrollment or new life events
  • Responsible for creating and monitoring client interactions via CRM system
  • Escalate non-routine inquiries and issues to Benefits Specialist and/or Benefits Manager
  • Participate in client related meetings as needed
  • Assist with client audits as requested
  • Assist with related special projects as needed
  • Summarized complicated topics into simple formats for better understanding
  • Demonstrated respect, friendliness and willingness to help wherever needed
  • Carried out day-day-day duties accurately and efficiently
Customer Service Representative, 11/2021 to 06/2022
Advanced Drainage SystemsPerry, GA,
  • Answer incoming call center questions about insurance policies and insurance coverage issues, as well as consumer complaints and general inquiries
  • Verify new customers coverage and present policyholders with proof of insurance paperwork
  • Keep track of all customer inquiries and follow up to verify that all questions are answered regarding customer policies
  • Handle complaints, present appropriate solutions, and alternatives within the timeframes set, and follow up to ensure that the issue has been resolved
  • Handles each interaction with a genuine desire to connect with the caller while adapting the support to the customer's needs takes ownership of each interaction while advocating for the customer
Customer Service Representative, 05/2020 to 10/2021
Suddath CompaniesDulles, VA,
  • Safety and compliance, Answer incoming call center questions about insurance policies and insurance coverage issues, as well as consumer complaints and general inquiries
  • Verify new customers coverage and present policyholders with proof of insurance paperwork
  • Keep track of all customer inquiries and follow up to verify that all questions are answered regarding customer policies
  • Handle complaints, present appropriate solutions, and alternatives within the timeframes set, and follow up to ensure that the issue has been resolved
  • Handles each interaction with a genuine desire to connect with the caller while adapting the support to the customer's needs takes ownership of each interaction while advocating for the customer
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Cultivated customer loyalty, promoted repeat business and improved sales
  • Educated customers about billing, payment processing and support policies and procedures
  • Met customer call guidelines for service levels, handle time and productivity.
Claims Adjuster, 02/2020 to 04/2020
Gpm InvestmentsEdgewood, IL,
  • Gather information from sources, such as police reports
  • Investigating each claim, evaluating facts, applying coverage, accurately documenting the file and paying what is owed
  • Applying knowledge of state and federal laws, statutes and insurance regulations through the claim handling process
  • Investigate and process insurance claims filed by policyholders
  • Interview claimant and witnesses to gather pertinent information
  • Perform review of all policies and evaluate coverage of claims taking new claims
  • Evaluated insurance policies and analyzed damages to determine coverage
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information
  • Evaluated evidence with ultimate goal of creating positive outcomes for client's claims
  • Reviewed police reports, medical treatment records and physical property damage to determine extent of liability
  • Examined claims forms and other records to determine insurance coverage
  • Answered customer questions regarding deductibles.
Deli Manager, 04/2010 to 12/2020
FrysCity, STATE,
  • Maximized customer satisfaction scores by training employees well and implementing strong customer relations standards
  • Hired qualified staff to fill opener shift and closing shift positions
  • Scheduled over 8 employees by assigning shifts
  • Completed monthly inventories of food and material stocks
  • Updated displays, cases and other customer-facing areas to increase sales of special items
  • Worked with customers placing large or specialized orders, providing samples and recommendations and responding to requests
  • Managed productivity through efficient scheduling, task prioritization and process streamlining
  • Implemented processes and procedures to keep employees on task and workflows running efficiently
  • Greeted customers with pleasant demeanor, answered questions and responded to inquiries, effectively improving business relationships
  • Weekly checking all invoices were paid and that all product was received, if missing any product the next step was to file for credit, and following up that credit was received.
Education and Training
High School Diploma: , Expected in 05/2009
Paradise Valley High School - Phoenix, AZ
GPA:

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Resume Overview

School Attended

  • Paradise Valley High School

Job Titles Held:

  • Health Assistant Customer Service
  • Employee Engagement Coordinator
  • Customer Service Representative
  • Customer Service Representative
  • Claims Adjuster
  • Deli Manager

Degrees

  • High School Diploma

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