insurance qualifier resume example with 5+ years of experience

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

CUSTOMER SERVICE REPRESENTATIVE & MEMBER ENGAGEMENT COORDINATOR PROFILE Experienced Work from Home Representative who is able to create an efficient work environment based on the company’s work at home guidelines. Adapt at utilizing computer productivity software, maintaining high levels of customer service, and being adaptable to a given situation. Specializes in technical support, inbound, outbound, and incoming phone sales/metrics/appointments, and exceeding customer expectations.

  • Persuasive Negotiations
  • Policy Adjustment Knowledge
  • Policy Renewals
  • Vision and Dental Insurance
  • Policyholder Communication
  • Quote Information
  • Claims Information Gathering
  • Client Needs Analysis
  • Insurance Policy Sales
  • Claims Reporting Systems
  • Policy Feature Explanations
  • Quotes and Sales
  • Insurance Coverage Verification
  • Administrative Support
  • Medicare Compliance
  • Customer Billing
  • Customer Complaint Resolution
  • Billing Inquiries
  • Licensing Requirements
  • Demographics Information
  • Persuasive Selling
  • Team Meetings
  • Patient Benefits Confirmation
  • Consultative Selling Techniques
  • Promotions and Marketing Strategies
  • Benefits Explanations
  • Store Displays
  • Providing Feedback
  • Requirements Reviews
  • Insurance Practices
  • Insurance Claim Regulations
Work History
Insurance Qualifier, 10/2022 to Current
Quantum Insurance SolutionsCity, STATE,
  • Answer inbound and outbound calls helping Medicare members gain all their benefits during our Annual Enrollment Period (AEP).
  • As a Qualifying Specialist, I am based off of metric set goals for members helped and successful qualified transfers, and work using Xen Auto Dialer, properly dispositioning calls in a timely manner to ensure goals are met hourly/daily.
  • Live Chat Support Specialist helping Medicare members who request help or more information by chat.
  • Member Data Entry and Sensitive information updates.
  • Maintained high standards of customer service by building relationships with clients.
  • Approached potential clients by using direct marketing mailings and phone contacts.
  • Spent ample time with each customer, verbally reviewing and explaining documents for client comprehension.
  • Built relationships with clients using active listening and issue resolution to provide excellent service.
  • Explained advantages, features and disadvantages of various policies to promote sale of plans, boosting overall sales 100%.
Coordinator of Member Engagement, 02/2017 to 11/2022
Signify HealthCity, STATE,
  • No More Work Available – Laid Off)
  • Answer and Callback Members with various Healthcare Plans to schedule/cancel/or reschedule In – Home Health Evaluation Visits using 2.0 and Five9 Auto Dialer, update and correct Members information related to their health plan using correct Call Dispositioning and Member Engagement Coordinator tool guide for reference, and exceed member scheduled appointment Metrics goals.
  • Used multiple information systems to analyze interactions and deliver detailed results.
  • Handled phone calls related to members' accounts or general questions about products and services.
  • Projected enthusiasm, courteousness and confidence while conducting member transactions.
  • Managed member relationships by resolving problems.
  • Identified members' needs and matched to product or service in best interest.
  • Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
Customer Service Specialist & Trouble Shooting , 03/2020 to 09/2022
AmazonCity, STATE,
  • Assisted Amazon Members with account troubleshooting issues, replaced products, delivery issues, refunds and billing, promotions and new item alerts, and customer service related questions and answers.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Took payment information and other pertinent information such as addresses and phone numbers to place orders.
  • Resolved concerns with products or services to help with retention and drive sales.
  • Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
  • Answered average of 150 calls, emails and faxes per day, addressing customer inquiries, solving problems and providing product information.
  • Applied basic sales strategy to engage customers and present solutions to suit individual needs.
  • Offered internal and external customers first-rate customer service to maximize satisfaction and business success.
  • Surpassed performance goals by approaching interactions with resourcefulness, organization and customer-centric solutions.
  • Collected customer feedback and made process changes to exceed customer satisfaction goals.
  • Carried out opening and closing functions to meet operational needs underpinning strong customer service.
  • Assisted customers with needs such as opening accounts, depositing or transferring funds, updating account details and signing up for new services.
  • Recorded product or service failure complaints and notified appropriate departments.
  • Devised innovative strategies to improve customer satisfaction scores and meet company goals.
  • Maintained financial accounts by processing customer adjustments.
High School Diploma: , Expected in 2013
James Madison High School - ,
GPA: 3.8
  • Customer service expert
  • Flexible to work all hours
  • High-speed Internet connection and capable home computer
  • Able to multitask on a regular basis
  • Independent worker who does not need supervision
  • Extremely reliable
  • Able to learn new products or procedures quickly
Additional Information

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Resume Overview

School Attended

  • James Madison High School

Job Titles Held:

  • Insurance Qualifier
  • Coordinator of Member Engagement
  • Customer Service Specialist & Trouble Shooting


  • High School Diploma

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