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

Ability to direct multiple complex projects from concept to fully operational status. Goal-oriented individual with strong leadership capabilities. Demonstrated proficiency with Microsoft products and Workforce Management applications. Organized, highly motivated, and detail-directed problem solver. Proven ability to work in unison with staff, peers, and leaders.

Core Qualifications
  • 15 years health care and customer service, 4 years training and 2 years quality assurance experience.
  • Received Certificate of Excellence in Customer Service 2011, 2012 and 2013.
  • Assisted committee in revising quality guidelines; resulting in additional 2% increase in QA scores.
  • Trained and evaluated incumbent call center staff.
  • Successfully refined and implemented 4 new Call Center projects.
  • 5 years management experience.
  • Effectively manage a multi-dimensional staff.
  • Raised multiple staff achievement objectives from 87.4% to 97.7%.
  • Revised production process to raise productivity; achieved 45.7% increase in production.
  • Streamlined work flows to reduce turn-around times by 67.3%.
Experience
Marketing Manager, 05/2013 to Current
The Scalable CompanyAustin, TX,
  • Overall management of inbound calls received as a result of direct response television advertising and various other forms of marketing
  • Coordinate and manage multiple bilingual inbound marketing vendors and one call routing agency to minimize abandonment and optimize customer experience and conversion
  • Monitor routing dashboard and scrutinize data files to ensure integrity
  • Evaluate call center performance through call monitoring, test calls and data analysis
  • Address and manage all data requirements and issues related to inbound telemarketing, CRM system and vendors
  • Write copy for call center scripts and tests; translate into code and upload into web based platforms
  • Provide call center training and documentation of procedures and guidelines for script handling
  • Assist VP of Marketing with evaluation and approval of proposed DRTV media buys
  • Develop and execute successful mobile marketing strategies and campaigns
  • Manage text message service provider and software to develop campaign structures and text sequencing
Reimbursement Coach , 11/2008 to 05/2013
Noridian Administrative ServicesFargo, ND,
  • Manage daily operational activities of Reimbursement, appeals and Patient Assistance Programs in a call center environment
  • Prepare and distribute reporting
  • Design work flows; manage productivity volumes
  • Develop and deliver training to ensure each team member maintains a high level of attention to detail
  • Perform audits and provide constructive feedback and suggestions for program improvements
  • Deliver corrective actions, develop performance improvement plans and conduct employee performance reviews.
  • Process bi-weekly payroll for all direct reports
  • Coordinate annual new hire training initiatives
  • Represent company in client meetings and report operational trends and metrics
Medical Review Analyst, 02/2005 to 11/2008
Nuvance HealthCoatesville, PA,
  • Perform pre-pay and post-pay workman's compensation medical claim review and make medical determinations and coverage decisions and payment recommendations in accordance with published practices, policies and procedures for each state of jurisdiction
  • Ensure claims are filed with proper documentation and are free of potential non-coverage misrepresentations or fraud
  • Respond to clients and providers with issues and concerns regarding medical review
Front Office Coordinator, 07/2004 to 02/2005
Common SpiritGlendale, AZ,
  • Responded to 12 incoming phone lines for group of seven physicians Scheduled appointments for 150+ patients weekly.
  • Acted as primary contact between physician clients and billing office, Verified insurance coverage, collected co-pays and obtained orders and referrals prior to scheduled services.
  • Coded and transcribed written diagnosis into ICD-9 format.
Patient Account Representative III, 01/2002 to 07/2004
Cardiovascular ConsultantsCity, STATE,

•Generated private insurance, HMO, PPO, Medicaid and Medicare billing claims for a 15-physician practice.

•Interacted with carriers such as Coventry, United Healthcare, Aetna and Family Health Partners.

•Resolved denials, credit balances and credentialing issues.

•Posted cash applications, entered charges and discussed billing issues with patients, doctors and insurance providers.

Patient Account Representative, 07/1999 to 01/2002
Research Psychiatric HospitalCity, STATE,
  • Supported billing and collections for an 80+ bed inpatient and outpatient facility
  • Interacted with insurance companies, case managers, patients and families in reviewing insurance verification for services
  • Estimated reimbursement by third-party payers, prorated accounts and calculated contractual allowances for inpatient/outpatient claims
Education
Bachelor: Management and Human Relations, Expected in 2009
MidAmerica Nazarene University - Olathe, KS
GPA: Cum Laude

Management and Human Relations Cum Laude

Associate of Business: , Expected in 2007
Metropolitan Community College - Kansas City,
GPA:
Skills

Management, supervision, strategic planning, billing and reimbursement, call center operations, customer service, data analysis, insurance, payroll, performance evaluation, quality assurance, excellent written and oral communications

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Resume Overview

School Attended

  • MidAmerica Nazarene University
  • Metropolitan Community College

Job Titles Held:

  • Marketing Manager
  • Reimbursement Coach
  • Medical Review Analyst
  • Front Office Coordinator
  • Patient Account Representative III
  • Patient Account Representative

Degrees

  • Bachelor
  • Associate of Business

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