Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Objective: Individual with strong reasoning ability looking to contribute adequate experience in a medical field. Profile: Over twenty five year's successful in Medical Collections/Customer Services/Training experience with consistently increasing responsibilities in employee training. Highly effective in problem solving. Demonstrates strong organizational and inter-personal skills. Resourceful management skills in staff training and motivation. Proven ability to effectively to develop strong leadership and communication skills via quality assurance. Hard-working Supervisor with exceptional experience leading teams, delivering results, and exceeding expectations. Creative and motivated leader adept at utilizing exceptional design and planning strengths to accomplish complex projects. Skilled in teaching new concepts and best practice strategies. Accomplished Supervisor focused on meeting customer expectations and achieving company goals. Drives success by directing high-producing teams while developing lasting employee rapport. Exceptional knowledge of cost-reduction methods and streamlining production processes. Energetic Supervisor successful at motivating and building positive team dynamics to accomplish aggressive goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success. Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.

  • Knowledgeable in Epic, Emdeon

Work History
Medical Claims Supervisor, 12/2014 - Current
Dupage Medical Group Blue Island, IL,
  • Leaders in nationally recognized health system, Is responsible for resolving Hospital and or provider focused issues (educational needs, contract verification, participation status, high dollar claims payment discrepancies.
  • Responsible for complete and accurate processing of claims.
  • Excellent customer services and ensure that accurate information is collected to ensures all accounts contain comprehensive and accurate data to provide for optional reimbursement.
  • Created efficient work schedules for each team member to maintain deadlines and fully staff shifts.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Measured effectiveness of customer success by defining operational metrics, tracking systems and reporting to executive team.
  • Performed annual evaluations and reviews for large staff of employees.
  • Evaluated employee performance and coached and trained to improve weak areas.
Medical Insurance Supervisor/Customer Service, 09/2013 - 05/2014
Greif Brothers Charlotte, NC,
  • Leaders in providing information technology Supervisor,Customer ServiceAn accomplished leader, responsible for the supervision of twenty plus direct reports.
  • Supporting healthcarethrough Marketplace and Medicare/Medicaid delivering information regarding eligibilty and plan enrollments for the affordable care act.
  • Provided weekly monitored perfonnance observations, with a tremendous focus oncoaching representatives to ensuring excellent consumer satisfaction and demonstrated listening skill in achieving successful del very of accurate information.
  • ProfessionalAccomplishments:);;> Perform tasks to assure service levelrequirement and adherence goals (such as real-time adherence (RTA) and average handle time are met.
  • Complete and deliveremployee performance appraisals.
  • Participate the interview process and recommend hiring contact center staff.
  • Attend calibration session for the purpose of keeping current on quality changes.
  • Achieved and met performance goals set by contact center management for scorecard quality and adherence.
  • Facilitate anddeliver training as required under department guidelinesincluding essentialjob training,initiatives, and up training.
  • Support andenforce contact center expectations as well's departmental and corporate policies and procedures.
  • Communicate pertinent program updates in a timely manner.
  • Maintain department records.
  • Maintain schedule flexibility due to business needs: anticipate assigned shift change at any time.
  • Complete anddeliver performance warnings applicable., Performed supervisory work in managing insurance account and providing impeccable service to clients.
  • Facilitated training for specialist and maintain quality of service through one on one coaching lo ensure quality Assurance standards were met.
  • Professional Accomplishment: Supervised/ManagedSupervised a team of medical collection specialists.
  • Prepare month end close-Out reports.
  • Maintained budgets for collection goals.
  • Coordinate for training of new staff.
Medical Account Specialist/Insurance Representative, 02/2007 - 07/2012
MD Anderson Cancer Center City, STATE,
  • Leaders in providing healthcare for Cancer, Responsible for overseeing in staff training and motivation: Responsible For completing daily menuwork files: Maintained the overall rate of at Least 15%.
  • Managed large volume of medical claims on daily basis.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
  • Paid or denied medical claims based upon established claims processing criteria.
  • Evaluated accuracy and quality of data entered into agency management system.
Customer Service Representative, 08/1998 - 02/2007
ACS Affiliated Computer City, STATE,
  • Served as a medical account specialist over large insurance accounts balance.
  • Provided constant innovation in developing to improve staff training.
  • Maintained large adjustments and transfer of credit balance.
  • Audit accounts/verification of insurance.
  • Assist with insurance billing of Commercial and HMO claims.
  • Reconciled customer's complaints.
  • Reconciled customers with account inquiries.
  • Reconciled customers with commercial insurance refunds.
  • Responsible for research and resolving customers' accounts.
  • Xerox is a global leader in BPO and It outsourcing.
  • Provided primary customer support to internal and external customers.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
No Degree: , Expected in
University of Houston - Downtown - Houston, TX
High School Diploma: , Expected in 05/1978
Washington High School - Lake Charles,LA,

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School Attended

  • University of Houston - Downtown
  • Washington High School

Job Titles Held:

  • Medical Claims Supervisor
  • Medical Insurance Supervisor/Customer Service
  • Medical Account Specialist/Insurance Representative
  • Customer Service Representative


  • No Degree
  • High School Diploma

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