Livecareer-Resume
Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Energetic and optimistic professional with over 20 years of experience assisting customers in solving complex issues in both the banking and healthcare industry, Strong knowledge of healthcare and banking regulations Proven history of fostering my attention to detail to meet team, individual and management objectives.

Skills

Customer Service

  • Relationship building
  • Customer satisfaction
  • Positive Language
  • Complaint procedures

Professional

  • Multi tasking
  • Medical claims system
  • Planning and preparation
  • Managing time

Personal

  • Listening Skills
  • Working with others
  • Proactive
  • Articulate
Experience
Quality Review Audit Senior Representative, 01/2014 to Current
AbmBinghamton, NY,
  • Responsible for accurate and timely adjudication of claims according to auditing guidelines
  • Audit claims by analyze, process, research, adjust and adjudicate with the use of accurate procedure/revenue and ICD10 codes ie copayments, deductible, e.t. are accurate
  • Audit claims based upon contractural agreements
  • Provide audit evidence when procedural and/or financial errors have been observed
  • Notify business unit, manager or supervisor of issues that impact quality, i.e. pricer errors
  • Maintain quality and productivity standards of at least 95% of established goal
  • Assist with the training of new hires
  • Verify authorizations to ensure claims are pricing accordingly
Collections Supervisor, 01/2013 to 12/2013
Southwest AirlinesBelgrade, MT,
  • Manage a team of 6 to 8 medical collectors in their day to day standard work, staff developement, and improvement activities
  • Create development plans for associates and assist in their growth and development
  • Monitor, meausurement, and manage employee performance according to estabilished criteria
  • Provide information and feedback to management on an ongoing basis to ensure continous improvement in department processes
  • Utilize established relationships with peers to ensure that departmental goals are met on a daily basis
  • Responsible for the development of recruiting procedures to ensure departmental standards exceed expectation
  • Implement training practices that would ensure that team is knowledgeable about department changes and updates
Customer Service Supervisor II, 05/2011 to 10/2012
AbmBloomington, CA,
  • Managed a team of customer service representatives that answered calls for the broker teams and customers.
  • Acknowledged customer issues and resolved their problems quickly and efficiently.
  • Assisted clients in understanding their available options and helped them select the right service plans for their needs.
  • Contacted existing and new brokers to personally manage and concerns regarding customers concerns regarding the marketing material, benefits and cover their needs and to explain how certain products could be useful to them.
  • Collaborated with Enrollment and Claims department to plan, develop and implement more effective ways to manage customer concerns.
  • Effectively communicated with other employees and upper management to ensure complete care of customers.
  • Remained calm and upbeat during calls with unsatisfied customers.
  • Work with team on improve first call resolutions and providing the customer with sound follow up.
  • Followed up with customers ensuring their satisfaction with their purchases.
  • Fulfilled administrative duties, including: completing and filing paperwork, directing a multi-line phone and setting appointments.
  • Developed and mentored team members to provide hospitable, professional service while adhering to established service models.
Collections Supervisor, 07/1995 to 03/2011
HSBC BankCity, STATE,
  • Managed a team of 18 senior collections representatives in a call center environment.
  • Assisted with training of new customer representatives in collections and helped motivate new team members with various incentives.
  • Created a phone call scheduling strategy when calling back customers in order to maintain consistent contact.
  • Delivered outstanding customer service in a variety of situations and settings related to account management.
  • Ensured client database was free from mistakes regarding name, address and other forms of contact information.
  • Investigated accounts that had possible errors in balances by using accounting system software.
  • Followed all regulations regarding fair debt practices and privacy.
  • Maintained positive relationships with customers in order to return their accounts to good standing.
  • Negotiated terms of payment for customers in order to resolve delinquent accounts.
  • Operated a computerized customer service call system in order to contact clients about accounts.
  • Negotiated terms of payment for customers in order to resolve delinquent accounts.
  • Responsible for managing my queue and clearing all complex customer issues or concerns.
Education and Training
Bachelors of political science: , Expected in
Morgan State University - Baltimore, MD,
GPA:
High School Diploma: , Expected in 06/1992
Alexis I. Dupont High School - Greenville, DE,
GPA:
Activities and Honors

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Resume Overview

School Attended

  • Morgan State University
  • Alexis I. Dupont High School

Job Titles Held:

  • Quality Review Audit Senior Representative
  • Collections Supervisor
  • Customer Service Supervisor II
  • Collections Supervisor

Degrees

  • Bachelors of political science
  • High School Diploma

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