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

Over six years of proven supervisory responsibility. Extensive experience recruiting, developing and managing clinical staff. Extensive knowledge of medical insurance, including Medicare, Medicaid, and commercial insurance. Extremely well-versed in HIPAA.

Education and Training
Bachelor of Arts: Mass Communication, Expected in 2003
-
Winthrop University - Rock Hill, SC
GPA:

Minor in Political Science

Skill Highlights
  • Proficient in Microsoft Word
  • Proficient in Microsoft Excel
  • Familiar with Microsoft PowerPoint
  • Familiar with Microsoft Access
  • Typing speed approximately 70 wpm
  • Proven customer service skills
  • Proven time-management skills
  • Proven multi-tasking abilities
Professional Experience
Operations Analyst, 10/2011 - Current
Freshly Austell, GA,
  • Contract cycle processing on a monthly and quarterly basis for assigned contracts
  • Identify cycle process improvements
  • Interface with HMS Program Directors to discuss variances on billing results, revenues, and problem resolution
  • Interface with clients as requested on expanded scope projects and clients calls
  • Intake of source data for analysis
  • Provide on-the-job training and/or review for more junior analysts
Eligibility Operations Supervisor, 03/2011 - 09/2011
Health Management Systems City, STATE,
  • Supervised a functional unit of 18 eligibility case workers servicing four different Medicaid agencies
  • Ensured that incoming calls were handled in a timely manner
  • Ensured that all checks sent to HIPP (Health Insurance Premium Payment program) members were sent for the correct amount and in a timely manner
  • Assisted with the creation of client-specific training documentation
  • Monitored both the quality and production of the eligibility case workers
  • Handled all escalated calls, working within company guidelines to resolve the cases to the customer's satisfaction
Medicare Buy-In Supervisor, 09/2006 - 02/2011
Health Management Systems City, STATE,
  • Supervised a functional unit of two Medicare Buy-In specialists for the Commonwealth of Kentucky
  • Responsible for ensuring that all Medicare Buy-In cycles were processed in a timely fashion
  • Assisted the Commonwealth with the resolution of Medicare Buy-In problem cases
  • Conducted training and re-training sessions for the Buy-In specialists as needed
  • Assisted with the creation of project-related documentation for the Buy-In unit
  • Monitored both the quality and the production of the Medicare Buy-In specialists
Verifications Supervisor, 10/2004 - 08/2006
Health Management Systems City, STATE,
  • Supervised a functional unit of approximately 12-15 insurance verification specialists servicing six different states' Medicaid agencies
  • Created documentation to train both the Third Party Liability (TPL) and non-TPL verification staffs
  • Conducted staff training and re-training as needed
  • Monitored both the quality and production of the insurance verifiers
  • Assisted with invoicing and other projects as needed

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Resume Overview

School Attended

  • Winthrop University

Job Titles Held:

  • Operations Analyst
  • Eligibility Operations Supervisor
  • Medicare Buy-In Supervisor
  • Verifications Supervisor

Degrees

  • Bachelor of Arts

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