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unemployment claims specialist resume example with 10+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Motivated Customer Service Coordinator with experience successfully managing and monitoring eligibility information for members and groups. Highly skilled at facilitating program approval or denial through qualifications assessment, fact checking and record keeping. Confident and committed to promoting positive customer outcomes through dynamic communication and exemplary engagement skills.

Skills
  • Self-Motivated
  • Decision-Making
  • MS Office
  • Attention to Detail
  • Effective communication skills
  • Applicant engagement
  • Application Review
  • Planning and Coordination
Work History
01/2021 to 08/2022 Unemployment Claims Specialist Merakey | Weatherly, PA,
  • Communicated with people from various cultures and backgrounds on application process.
  • Interviewed applicants and explained scope of different available benefits.
  • Scheduled appointments with applicants to gather information and explain benefits processes.
  • Developed extensive fact-checking and research skills as result of continuously reviewing different programs and options.
  • Documented all communication with applicants and inputted information into system using Beacon Portal.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
  • Promoted and maintained integrity of unemployment insurance (UI) programs through prevention, detection, investigation, establishment, recovery and prosecution of UI overpayments, Fraud, made to claimants,
  • Cross-match data with other state and federal government agencies to confirm work status and unreported earnings of people who claim unemployment insurance benefits.
  • Conduct random investigations to review claimants eligibility, weekly work searches, and work search contacts.
  • Identified documents provided by claimant, which may result in denial of benefits, if considered Fraudulent.
  • Answered constant flow of customer calls/chats with minimal wait times.
  • Ensured all documents were uploaded to claimant portal in timely manner (by due dates).
  • Managed over 30 calls per day
  • Participated in team-building activities to enhance working relationships
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
  • Worked flexible hours across night, weekend and holiday shifts
08/2017 to 01/2021 Member Engagement Coordinator Signify Health | City, STATE,
  • Gathered and organized materials to support operations.
  • Received and responded to customer requests via letters, emails, telephone calls and in-person interactions.
  • Entered data, generated reports, produced tracking documents.
  • Trained new employees on day-to-day work on complex problems.
  • Outgoing/incoming phone calls to/from Medicare and/or Medicaid health plan members to offer, explain and schedule free in home health risk evaluation
  • Follow provided CMS and health plan approved script when discussing health risk evaluation opportunity with potential member; ensure member understands and is comfortable with terms of evaluation
  • Answer client questions truthfully and proficiently
  • Accurately record notes on member accounts related to their evaluation and status
  • Schedule contracted providers to conduct health risk evaluation of members in their homes and or virtually (during pandemic)
  • Schedule contracted providers within assigned geographic area; allowing for appropriate time and distance between appointments
  • Adjust and reschedule appointments with both members and contracted providers as needed; communicate with Physician Services team members and Scheduling Managers when cancellations and rescheduling occurs
  • Managed over 50 customer calls per day
04/2012 to 08/2017 Administrative Coordinator/Logistics Specialist AJR Trucking/Joe's Car Shipping | City, STATE,
  • Prepared detailed documents and reports in adherence administrative processes.
  • Monitored and directed incoming mail and prepared outgoing mail.
  • Collaborated in timely processing of billing and accounts receivables.
  • Worked closely with others to accomplish timely invoicing and accounts receivables.
  • Coordinated flights, ground transportation and hotel accommodations.
  • Made travel arrangements for staff members.
  • Completed bi-weekly payroll for 3 employees
  • Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
  • Analyzed and solved multi-faceted problems that effected executive leaders and business initiatives.
  • Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
Education
Expected in to to | Computer Information Technology Central Texas College, Killeen, TX GPA:
Certifications

Texas All Lines Adjusters License

Xactimate X1 Training

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Resume Overview

School Attended

  • Central Texas College

Job Titles Held:

  • Unemployment Claims Specialist
  • Member Engagement Coordinator
  • Administrative Coordinator/Logistics Specialist

Degrees

  • Some College (No Degree)

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