member service representative resume example with 11+ years of experience

Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - - : - -
  • Agile principles
  • Accounts payable understanding
  • Stakeholder relations
  • Implementation management
  • Planning and coordination
  • Customer service
  • Problem resolution
  • Friendly, positive attitude
  • Multitasking
  • Planning & organizing
  • Conflict resolution
  • Account management
  • Microsoft Office expertise
  • Customer relations
  • Data evaluation
  • Senior leadership support
  • Business development understanding
01/2020 to 01/2023
Member Service Representative Gcs Credit Union O'fallon, IL,
  • Delivered high level of service to customers in effort to build upon relationships for future.
  • Verified patient demographics and insurance information in electronic system.
  • Processed telephone calls and triaged problems in accordance with company standards and policies.
  • Communicated with insurance offices to verify service eligibility for authorization requests.
  • Maintained customer accounts and information in electronic reporting system.
  • Obtained consent for healthcare services from patients to document in chart following rules and regulations.
  • Helped patients obtain health care services by setting up referrals.
  • Explained policies, procedures and services to patients.
  • Addressed patients' complaints-head on, investigated concerns and worked with medical staff to devise solutions.
01/2018 to 03/2020
Customer Service Representative Axalta Coating Systems Huntsville, AL,
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Demonstrated excellent communication skills in resolving product and consumer complaints.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
  • Assisted customers with making payments or establishing payment plans to bring accounts current.
  • Informed customers about billing procedures, processed payments and provided payment option setup assistance.
  • Asked probing questions to determine service needs and accurately input information into electronic systems.
  • Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
03/2015 to 01/2018
Data Processing Specialist Guaranty Bancshares, Inc. Rockwall, TX,
  • Audit claims for providers hospital claims and doctor claims ∙Insurance verification ∙ Upon termination of a participant due to a qualified event, providing complete COBRA services. Monthly client billing, including reconciliation of bills generated by the system, response to any hospital correspondence ∙client inquiries and tracking of payment status.
  • Identified errors in data entry and related issues by mentioning to supervisors for resolution.
  • Compared old and newly received documents to ensure accuracy and rectified mistakes. Input client information into spreadsheets and company database to provide leaders with quick access to essential client data.
  • Answered data questions to clients and higher-up employees.
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Handled client inquiries with exceptional professionalism and enthusiasm.
  • Informed customers about product lines and services offered by company.
  • Provided customer service and issue resolution to increase QA satisfaction levels.
02/2011 to 03/2015
Enrollment Representative Change Healthcare Felton, PA,
  • Taking Inbound phone calls Providing information on general Medicare eligibility and benefits.
  • Enroll members in different Medicare advantage plans for open enrollment.
  • Medicare billing and coding and resolve claims issues.
  • Working in systems such as Microsoft Word, PowerPoint, Outlook and Excel.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • Analyzed information from interviews, educational, and medical records, consultation with other professionals and diagnostic evaluations to assess clients' abilities, needs and eligibility for services.
  • Analyzed information from interviews, educational, and medical records, consultation with other professionals, and diagnostic evaluations to assess clients' abilities, needs, and eligibility for services.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Demonstrated self-reliance by meeting and exceeding workflow needs.
  • Demonstrated leadership by making improvements to work processes and helping to train others.
Education and Training
Expected in 03/2019 to to
Associate of Science: Business Management
Keiser University - Tampa, FL,
  • Consistently maintained high customer satisfaction ratings.
Activities and Honors
  • Member, Small Business Association (2008 - present)
  • Sales and expertise training - 2011
  • Medicare Training -2013
  • cobra and billing administration 2015

Diplomatic customer service professional experienced in defining and analyzing customer requests to resolve issues. Accurate in documenting customer concerns and dedicated to maintaining deep knowledge of products and promotions. Confident communicator recognized for consistently receiving excellent customer feedback.

Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.

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Resume Overview

School Attended

  • Keiser University

Job Titles Held:

  • Member Service Representative
  • Customer Service Representative
  • Data Processing Specialist
  • Enrollment Representative


  • Associate of Science

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