Membership Analyst resume example with 20+ years of experience

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

Dedicated Management Professional with over 30+ years history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Motivated to learn, grow and excel in the Scrum Master Field

  • Project Management Curriculum
  • Strategic Planning Training/Coaching
  • Managing Operations and Efficiency
  • Project Management
  • Employee Coaching and Motivation
  • Issue and Conflict Resolution
  • Team Leadership
  • Productivity Performance
  • Data and Analytics
  • Data Accuracy
  • Document Preparation
  • Contract Implementation
Work History
Membership Analyst, 11/2021 to Current
Bluecross Blueshield Of South CarolinaCharleston, SC,
  • Produces 100's of health/dental benefit books using customer software
  • Document production includes research of group files, customization of benefit language, correction of group documents, editing revisions coordination with marketing, underwriting, quality control and other departments to ensure appropriate group structure, status, and benefits
  • Ensures all group/member level distribution procedures/systems are access and utilized in accurate/timely manner to include imaging of documents, web migration of books, maintaining updates to workload tracking database(Access), sending product to print, and overall follow-up and follow-through
  • Manage and performed various duties/responsibilities as assigned to include responding to all inquiries pertaining to group’s book and /or contract, and special projects as assigned
Customer Service Training Specialist/Coach, 08/2019 to 11/2021
Texas Health & Human Services CommissionGrand Prairie, TX,
  • Analyzed Accountability, Implementation, and Measurement (AIM) reports and First Call Resolution (FCR) report to report back to management any process improvements that need to be implemented
  • Maintained high regard for members, customers and/or beneficiary privacy in accordance with corporate confidentiality, privacy and security policies and procedures
  • Responsible for coaching over 3 teams and various groups within National Alliance at one time
  • Perform audit reviews via one-on-ones, remote monitoring, and real-time monitoring.
Training Specialist I, 01/2017 to 08/2019
Blue Cross Blue ShieldCity, STATE,
  • Lead well over 10 training projects that included conducting assessments to improve training module for future classes
  • Provides guidance, coaching and perform trainer sessions as needed
  • Prepares appropriate reports and presentation materials as requested by management
  • Evaluated various training trends, techniques and/or programs that allowed for cross-training amongst training and coaching staff
Claims Customer Service Lead Coordinator, 01/2017 to 10/2017
Blue Cross Blue ShieldCity, STATE,
  • Coached, managed and direct over 40 advocates on how to follow Blue Steps and ensure that teams were giving accurate information to customer inquiries and help issues be resolved with First Call Resolution
  • Resolve challenging concerns from escalated members
  • Provide feedback to management about customer issues, claims, and statistics and maintain accurate records concerning issues
  • Selected to participate in first documented claims pilot training
  • Collaborated with team members to achieve target results
  • Actively listened to customers' requests, confirming full understanding before addressing concerns
Claims CSA II, 12/2015 to 01/2017
Blue Cross Blue ShieldCity, STATE,
  • Worked on Prestigious Muti-Tier Unit Team
  • Provided “White glove” customer service to every member
  • Properly handled 1,000's of customer phone calls using Service Mentor Blue Steps Program
  • Selected to cater to CRU (Campus Crusade for Christ, Inc.) members
  • Provided exemplary customer service to Cru’s (Campus Crusade for Christ, Inc.) dedicated organization and their benefit Administrators.
  • Worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
  • Used critical thinking to break down problems, evaluate solutions and make decisions
  • Worked within applicable standards, policies and regulatory guidelines to promote safe working environment
Lead Sales Manager, 08/2010 to 06/2014
Pier 1 ImportsCity, STATE,
  • Managed team of sales associates by providing leadership in increase of 50% in sales, customer service, operation, and problem resolution
  • Trained new sales associates
  • Opened and closed store, conducted daily accounting, and prepared nightly deposits.
  • Coached employees in successful selling methods and encouraged cross-selling for additional products and services
  • Attended weekly meetings to discuss and optimize strategies
  • Evaluated performance against goals and implemented appropriate development plans
  • Closed lucrative sales deals using strong negotiation and persuasion skills
Network Testing Engineer, 06/2000 to 07/2010
Verizon CommunicationsCity, STATE,
  • Designed, developed, and tested telecommunications remote testing manual for telecom specialists
  • Team lead between Verizon and 1000's of external customers to ensure on-time network upgrades
  • Provided training/assistance to personnel on how to support GNS and various systems
  • Provided awesome customer service to every customer and vendor
  • Carried out day-to-day duties accurately and efficiently
  • Delivered services to customer locations within specific timeframes
Bachelor of Science: Marketing/ Management, Expected in 05/1992
South Carolina State University - Orangeburg, SC

CSM- Certified Scrum Master

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Resume Overview

School Attended

  • South Carolina State University

Job Titles Held:

  • Membership Analyst
  • Customer Service Training Specialist/Coach
  • Training Specialist I
  • Claims Customer Service Lead Coordinator
  • Claims CSA II
  • Lead Sales Manager
  • Network Testing Engineer


  • Bachelor of Science

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