LiveCareer-Resume

service delivery ops resume example with 14+ years of experience

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

Versatile and skilled in all aspects of customer relationship management and satisfaction. Client-first attitude toward accomplishing tasks. Dependable and diligent individual with years of experience working in Customer Service.

Skills
  • Responding to Difficult Customers
  • Transaction Processing
  • Calm and Professional Under Pressure
  • 40 wpm Typing Speed
  • Customer Service
  • Call Documentation
  • Upbeat and Positive Personality
  • Creative Problem Solving
  • Data Entry
  • Verbal and Written Communication
  • Multitasking and Prioritization
  • Understanding Customer Needs
  • Issue and Complaint Resolution
  • Efficient and Detail-Oriented
  • Multi-Line Phone Systems
  • Microsoft Office
  • Strong Analytical and Problem Solving Skills
  • Teamwork and Collaboration
  • Inbound and Outbound Calling
  • Computer Proficiency
  • LiveChat Messaging
  • Time Management
  • Call Volume and Quality Metrics
  • Administrative and Office Support
  • Patient and Empathetic
  • Excellent Attention to Detail
Experience
Service Delivery Ops, 11/2019 to Current
Christus HealthUniversal City, TX,
  • Researched and reviewed information to determine the validity of insurance claims and contacted companies and customers about decisions.
  • Followed all company procedures to keep data confidential.
  • Gathered proper documentation and data to prepare claims for submission.
  • Assessed processing reports each day to effectively submit claims.
  • Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records.
  • Managed projects and served as primary liaison between client and multiple internal groups to clarify goals and meet standards and deadlines.
  • Supported business processes and end-users by monitoring system operations and resolving issues.
  • Compiled and organized research data to produce reports and graphs.
  • Used findings from research and data to make recommendations for business.
  • Identified and resolved data issues to drive accuracy and integrity.
  • Maintained policy, procedures, work instructions and projects for quality and continuous improvement agendas.
  • Set and achieved product quality objectives while meeting product specifications.
  • Investigated performance to maintain employee adherence to quality and safety policies.
  • Coordinated with management team to prioritize sustainable cost savings plans.
  • Researched and analyzed laws and statutes to assist in making just decisions.
  • Resolved customer complaints and adjusted policies to meet changing needs.
  • Established and enforced clear goals to keep employees working collaboratively.
  • Provided ongoing training to address staff needs.
  • Complied with company policies, objectives and communication goals.
  • Accurately processed large volume of medical claims every shift.
Provider Enrollment Specialist, 02/2019 to 10/2019
Texas Health & Human Services CommissionStephenville, TX,
  • Maintained provider enrollments for Texas Medicaid.
  • Utilized effective active listening, interpersonal and communication skills in collaborating with different individuals on daily basis.
  • Kept watchful eye on physician expiration dates and contacted practitioners to inform when such dates were near.
  • Supported members through navigation of enrollment process to facilitate optimal decisions.
  • Completed and processed applications for enrollment.
  • Communicated program policies and enforced each.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Collaborated with team members to identify and accomplish agency objectives.
Program Specialist V, 03/2006 to 08/2017
Health And Human Services CommissionCity, STATE,
  • Facilitated smooth communication between team members, project directors and customers.
  • Improved program operations by incorporating feedback from employees, managers and consumers.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Educated customers on special pricing opportunities and company offerings.
  • Asked probing questions to determine service needs and accurately input information into electronic systems.
  • Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
  • Explained benefits, features and recommendations to maximize client retention.
  • Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
  • Assisted customers by phone and scheduled appointments and treatments.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • Called applicants to set up appointments and explain benefits processes.
  • Reviewed criteria for different aid programs to determine eligibility for various applicants.
  • Conducted interviews with applicants, explaining benefits process and which programs were available.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Juggled multiple projects and tasks to ensure high quality and timely delivery.
  • Demonstrated leadership by making improvements to work processes and helping to train others.
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Handled client inquiries with exceptional professionalism and enthusiasm.
Education and Training
High School Diploma: , Expected in 05/1XXX to Reagan High School - Austin, TX
GPA:

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Resume Overview

School Attended

  • Reagan High School

Job Titles Held:

  • Service Delivery Ops
  • Provider Enrollment Specialist
  • Program Specialist V

Degrees

  • High School Diploma

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