Membership Analyst resume example with 20+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
Home: (555) 432-1000
Cell:
resumesample@example.com
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
Skills
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 Carolina – Charleston, 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 Commission – Grand 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 Shield – City, 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 Shield – City, 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 Shield – City, 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 Imports – City, 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 Communications – City, 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
Education
Bachelor of Science: Marketing/ Management, Expected in 05/1992 South Carolina State University - Orangeburg, SC GPA:
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