Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Professional Summary
Client Service Professional with over thirteen years experience implementing and managing a range of client accounts, exceeding client expectations, offering strong organizational and analytical skills. Comprehensive knowledge of health insurance plans to identify client needs and recommend effective solutions. Easily adapts to changing situations and environments. Able to quickly learn and assimilate new information. Strong computer aptitude able to execute complex queries and data analysis.
Core Qualifications
Account Retention
Client-focused
Key Account Management
Professional Presentation
Computer proficient
Reports generation and analysis
Experience
03/2012 to 03/2014National Accounts Client Set-Up & Maintenance SpecialistCarter Lumber Inc | Winchester, VA,
Working as a client set-up specialist, was responsible for the timely completion of assigned client service changes and set up of new clients.
Responsible for completing 3 to 4 new client implementations and/or, existing client projects on a monthly basis.
The average number of service changes for existing clients was 100 individual locations, new client implementations averaged 800 individual locations Maintained a monthly completion rate of 92%.
Compiled and prepared Vendor Bid Summaries for negotiation in the Vendor Procurement Process for each implementation or new client assigned to me.
Managed, tracked, and reported project and / or implementation progress, using V-lookup, and Pivot tables using excel.
Validated & analyzed the data for each project and implementation assigned to me, checking for accuracy of cost, price, and service levels.
Researched and resolved vendor / client service and billing issues.
08/2011 to 2012Sales Team CoordinatorPgim Global Short Duration High Yield Fund, Inc. | Omaha, NE,
As a sales team coordinator, acted as liaison for up to ten life insurance wholesalers and the new business processing team.
Successfully assisted with the implementation of 152 accounts totaling 41 million dollars during the fourth quarter of 2011.
Proactively contacted financial vendors to obtain outstanding requirements on new submissions and actively follow up until paperwork was in good order Provided financial vendors and key firm contacts with support in the new business submission process including completion of necessary forms Tracked the status of 700 submitted cases for three assigned territory(s).
Provided the financial vendor, Internal Wholesaler, and External Wholesaler updates at critical points in the New Business and Underwriting Process.
Developed strong relationships with New Business Associates, External Wholesalers, and Internal Wholesalers and Financial vendors within each territory.
2010 to 2011Group Insurance Administration AnalystPool Administrators, Inc | City, STATE,
Connecticut High Risk Pool is a health insurance benefit program for individuals denied health insurance due to pre-existing conditions.
Updated contract changes upon renewal and processed cancellations.
Analyzed existing policy & procedure manuals to determine best practices.
Updated, designed, and produced a functional policy & procedure manual for High Risk Pool by conferring with team of customer service representatives.
Reduced contract-processing time from five days to three days by streamlining outdated processes.
2008 to 2011Group Insurance Development SpecialistPool Administrators, Inc | City, STATE,
Consulted with subject matter experts to develop program website, which included functionality, information flow, content, and screen layouts to write and design extensive policy & procedure manual, program operation guide, and customer service training materials.
Researched, interpreted, and applied more than fifty State/Federal mandates into benefit contracts.
Conducted market surveys of ten insurance carriers in Connecticut to develop baseline for eligibility and billing processes.
Coordinated activities to complete assigned tasks using Microsoft Office Excel 2007.
Provided technical specifications for eligibility, billing, and reporting processing systems.
2008 to 2009Group Insurance Development SpecialistPool Administrators, Inc | City, STATE,
Collaborated on the ACT-Connecticut project with team of 25 internal/external partners tasked to create, design, and implement health insurance benefit program for small employer groups with low income uninsured employees.
Consulted with subject matter experts to develop program website, which included functionality, information flow, content, and screen layouts to write and design extensive policy & procedure manual, program operation guide, and customer service training materials.
Researched, interpreted, and applied more than fifty State/Federal mandates into benefit contracts.
Conducted market surveys of ten insurance carriers in Connecticut to develop baseline for eligibility and billing processes.
Coordinated activities to complete assigned tasks using Microsoft Office Excel 2007.
Provided technical specifications for eligibility, billing, and reporting processing systems.
2008 to 04/2008Customer Service RepresentativePool Administrators, Inc | City, STATE,
As a temporary employee, placed in a newly created customer service team tasked with assisting inbound callers with questions regarding a Medicare Part D insurance assistance program for the State of Maryland.
Hired permanently following two-month temporary assignment based on excellent performance, knowledge, and work ethic.
Reviewed and processed all applications within established timelines.
2001 to 2006Employer Service ConsultantCIGNA Healthcare | City, STATE,
As primary contact engaged new and existing clients for all inquiries regarding case installation, eligibility, premium discrepancies and denied claims.
Managed book of business of 65 clients, which covered 85,000 members.
Successfully achieved and maintained 95% accuracy rating with implementation of new accounts and renewals of existing clients Reduced outstanding premiums by 77% ($400,000 to $90,000 ) for my book of business.
Designed and implemented the use of MS Outlook inbound faxing for a team of 30, which reduced misplaced enrollment forms by 80% and the average processing time by 40%
90% of my clients rated my service as exceptional.
1998 to 2001Eligibility Customer Service RepresentativeCIGNA Healthcare | City, STATE,
In a call center environment, provided timely and accurate information regarding manual and automated eligibility, and student verification to Human Resource administrators and CIGNA partners.
Maintained an average of six minutes of handling time for incoming calls, reducing time standard for average call of eight minutes, handling 120 calls per eight hour shift on average
Participated in six-week train the trainer course for a new system roll out for claims, billing, eligibility and call tracking.
Redesigned training materials for 30 full time employees Mentored and trained class of 10 temporary associates hired to handle annual spike in incoming calls associated with member open enrollment.
Skills
Ability to organize and complete multiple projects quickly
Creating business requirements for system development
MS Excel: Creating pivot tables, charts, and using V-Lookup to compare and validate large amounts of data
MS Word: Creating and formatting complex documents
Education
Expected in 1990High School Diploma | Business Management/Liberal Arts StudiesManchester Community College, Manchester, CTGPA:
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School Attended
Manchester Community College
Job Titles Held:
National Accounts Client Set-Up & Maintenance Specialist