LiveCareer-Resume

insurance and safety administrator resume example with 20+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary

Highly focused professional with 20+ years of direct customer service including insurance and healthcare assistance. I employ professionalism and superior communication skills to meet client and company needs. Excel at fact finding, analyzing, prioritizing and completing tasks while exhibiting professionalism and sound judgement. Exceptional organization skills, results-oriented and technically competent.

Skills
  • Vermont healthcare program knowledge
  • Case Management
  • HIPAA Compliance
  • Multi-task ability
  • Time Management
  • Insurance enrollment
  • Conflict resolution
  • Teamwork / Collaboration
  • Effective communication
  • Analytical and problem solving
Education
Community College of Vermont Winooski, VT, Expected in 04/2017 Associate of Science : Health Science - GPA :
Certifications

Essential Maintenance Practice - State of Vermont

I am certified with the State of Vermont's Essential Maintenance Practices (EMP). It is a law that creates a 'standard of care' with respect to lead paint stabilization and maintenance on rental units and daycare facilities that were built before 1978.

Vermont's Essential Maintenance Practices (EMP) are:

  • Perform a visual on-site inspection of interior and exterior surfaces to identify deteriorated paint.
  • Install window well inserts in all pre-1978 wooden window wells
  • Stabilize paint if more than one square foot of deteriorated paint is found on either interior or exterior surface within 30 days of identification or report by tenant.
  • Utilize lead safe work practices when disturbing paint as described by the VDH, which includes not using prohibited practices
  • Remove all visible paint chips from the ground on the property.
  • Perform specialized cleaning at the conclusion of any work, annually in common areas, and when the unit turns over.
Work History
PC Construction - Insurance and Safety Administrator
City, STATE, 01/2018 - 05/2019
  • Review incoming proposals and contracts
  • Validate incoming data to check information accuracy and integrity while independently location and correcting concerns
  • Provide assistance in managing health and safety programs aligned with industry standards
  • Obtain and enroll each project with proper insurance coverage
  • Monitor, track and file claims from 50+ job sites throughout eastern coast
  • Communicate with medical facilities and insurance company's to help with claims process
  • Collaborate with safety teams in most current regulations and practices
  • Prevention strategies to mitigate future risk
  • Document workflow technique
  • Create and maintain OSHA reports
State Of Vermont - Healthcare Eligibility and Enrollment Specialist
City, STATE, 01/2016 - 01/2018
  • Understood and thoroughly explained services provided to customers and potential customers
  • Analyze each case for eligibility and enrollment
  • Examine data to complete insurance applications or change of circumstances to ensure proper coverage
  • Processed eligibility, benefits verification and authorization requests
  • Investigate and interpret records to uncover errors, billing discrepancies with premiums and payment plan changes
  • Responsible to report fraud
  • Research, assist and resolve disputes in a professional and positive manner
  • Collaborate and cultivate close working relationships with supervisors, mentors, health insurance carriers and trouble shooting specialists to achieve resolution
  • Interact daily with insurance company's and their agents
  • Refer to other state programs when needed
University Of Vermont Medical Center - Registration and Financial Clearance
City, STATE, 07/2015 - 01/2016
  • Consent to treat, admit and collect co-pays and deductibles
  • Create, assign and prioritize financial classes
  • Acquire appropriate patient demographics
  • Research and assign diagnosis and billing codes
  • Correspond with insurance companies for patient eligibility and claim status
  • Create, edit and maintain spreadsheets
  • Skillfully achieve department goals, objectives, policies and procedures
  • Adhere to state, federal, third party payer compliance and billing regulations
  • Comply with laws, regulations for Medicare and Medicaid
  • Represent and interpret agency functions to clients, institutions, government agencies and other organizations
Fairpoint Communications - Administration, Customer Service and Sales
City, STATE, 07/1995 - 07/2015
  • Supervise and assist 30 representatives to maximize team knowledge and productivity by effectively training, monitoring and directing them in application best practices
  • Answer and direct minimum of 50 outbound/inbound phone calls per day
  • Diffuse volatile customers calmly and courteously
  • Identify and recommend changes to existing processes to improve accuracy, efficiency and quality service
  • Advocate, encourage and support staff to identify and resolve conflicts
  • Coordinate detailed work orders for repair
  • Adjust program mechanics to account for changing conditions
  • Foster a climate of collaboration between departments to assist in resolving problems
  • Resolve complex service issues, billing and technical problems
  • Document inquiries and comments thoroughly
  • Key member of Cut-Over-Sales and Service Team in transition form Verizon systems to Fairpoint systems

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Resume Overview

School Attended

  • Community College of Vermont

Job Titles Held:

  • Insurance and Safety Administrator
  • Healthcare Eligibility and Enrollment Specialist
  • Registration and Financial Clearance
  • Administration, Customer Service and Sales

Degrees

  • Associate of Science

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