Jessica Claire
, , 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - - -
Professional Summary
  • Enthusiastic [Job Title] eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of [Task] and [Task] and training in [Skill]. Motivated to learn, grow and excel in [Industry].
  • Reliable employee seeking [Job Title] position. Offering excellent communication and good judgment.
  • Hardworking and passionate jobseeker with strong organizational skills eager to secure entry-level [Job Title] position in [Type] environment. Ready to help team achieve company goals.
  • Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
  • Experienced [Job Title] with over [Number] years of experience in [Industry]. Excellent reputation for resolving problems and improving customer satisfaction.
  • Accounting
  • ACMS
  • Administrative skills
  • Billing
  • Clerical
  • CPR
  • Clientele
  • Customer service
  • Data entry
  • Faxes
  • Active Listening
  • Marketing
  • Microsoft Office Suite
  • Network
  • Performance management
  • Policies
  • Processes
  • Quality
  • Rapport
  • Recruitment
  • Safety
  • Multi-Phone Lines
  • Type 45 wpm/ Ten Key Skills
Work History
09/2019 to Current
Utilization Management Representative Banner Health Fort Collins, CO,
  • Develops prior authorization based upon policy, medical and clinical guidelines.
  • Serves as provider liaison by effectively interpreting clinical data and communicating case status.
  • Analyzes procedure requirements per service type and members medical policy.
  • Exceeds overall quality rating of 96% and average call handle time standard via telephone and written inquiries through client engagement.
  • Resolves clients questions and requests in a timely manner, solution-oriented approach, and empathetic tone.
  • Utilizes administrative skills to accurately execute 100% of referral requests into the AUMI system in accordance with the plan certificate.
  • Performed prior authorization review of services requiring notification.
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Supervised and maintained all utilization review documentation through [Software] {ACMS}.
  • Advocated for and strived to protect health, safety and rights of patient.
  • Maintained highest levels of patient satisfaction, generating referrals to maintain productivity levels for [Type] rehabilitation unit.
  • Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
06/2020 to 11/2020
Media Support Service Advisor Glaukos Chicago, IL,
  • Responsible for maintaining a high level of professionalism with customers and working to establish a positive rapport with every caller.
  • Resolved product or service problems by clarifying the customer’s complaint, determining the cause of the problem, selecting, and explaining the best solution to solve the problem, expediting correction or adjustment, and following up to ensure resolution.
  • Maintained customers financial accounts by identifying unrecognizable charges, canceling subscriptions, and processing refunds.
  • Exhibited high energy and professionalism when dealing with clients and staff.
  • Pleasantly greeted customers and asked open-ended questions to better determine needs.
  • Handled customer issues with confidence, using [Skill] to provide effective resolution.
  • Developed documentation and logs of implemented solutions and generated and submitted reports.
  • Investigated and resolved accounting, service and delivery concerns.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Recorded actions taken, issues resolved and [Type] information to effectively manage customer accounts.
  • Answered average of [Number] calls, emails and faxes per day, addressing customer inquiries, solving problems and providing product information.
02/2018 to 07/2019
Customer Service Representative LogistiCare City, STATE,
  • Served as a liaison of communication through the completion of clerical functions such as answered incoming calls, effectively fulfilling member requests, troubleshooted complaints, scheduled appointments, data entry, and handled sensitive information.
  • Provided exceptional customer service in actively listening to member needs, responded with a sense of urgency, and demonstrated consistent follow-up.
  • Answered multi-line phones and used active listening skills to assess client's issues and challenges.
  • Resolved [Product or Service] issues by clarifying customer's complaints, determining causes of problems and selecting best solutions.
  • Addressed on average [Number] inbound customer calls daily.
  • Responded to customer inquiries and queries to provide thorough and speedy resolutions.
  • Maintained customer account information database by canceling and updating customer accounts.
  • Processed information with high level of accuracy to satisfy client's needs.
  • Strengthened customer relationships and authored strategies to provide positive experience for customers.
10/2016 to 02/2018
Assistant Child Care Instructor Discovery Point City, STATE,
  • Executed recruitment and onboarding processes, inclusive of distribution of employment offers and benefit packages, composition of training and development plans, and solicitation of performance management feedback.
  • Implemented and sustained company’s social media presence by ensuring accurate and current information, while maintaining a network of clientele through marketing initiatives.
  • Mentored new employees while supporting complex dedicated suite of products and services.
  • Handled daily administrative tasks efficiently to minimize time away from children.
  • Created safe and engaging learning environment for groups of diverse children with various learning styles.
  • Added daily log information to permanent records outlining observations, meals and any medications administered for acute or chronic conditions.
  • Established and monitored customer service standards by employing recognized and comprehensive benchmarks.
  • Strengthened customer relationships and authored strategies to provide positive experience for customers.
Expected in
Bachelor of Science: Early Childhood Education, Business Administration & Management Studies
University of West Georgia - Carrollton, GA

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School Attended

  • University of West Georgia

Job Titles Held:

  • Utilization Management Representative
  • Media Support Service Advisor
  • Customer Service Representative
  • Assistant Child Care Instructor


  • Bachelor of Science

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