yyyyyy x. yyyyyy

901 englewood parkway, #m0000 xxxxxx xxxx , xxxx , xxxxx 00000 • (xxx-xxx-xxxx • abc@xyz.com

 

enthusiastic, solutions-focused professional eager to offer 9+ years of progressive experience in customer service, product / services education, data / claims management, call center support, and technical assistance toward maximizing an employer s success within a growth-oriented role.

 

profile of qualifications

 

         top performer who offers broad contracted experience within healthcare insurance operations and technical support areas, including demonstrating talents in building customer loyalty and driving business growth.

         out-of-the-box thinker who contributes superior attention-to-detail and strong troubleshooting skills while working among members and providers to resolve diverse issues in alignment with healthcare objectives.

         ambitious self-starter who plans, prioritizes, and completes tasks within fast-paced, high-pressure situations.

         excellent communicator who seamlessly interfaces among business teams, customers, and the general public.

 

professional synopsis

 

 

customer service representative tufts health plan of massachusetts

         utilized broad scope of medical industry knowledge and dynamic business acumen to provide superior customer support during a medicare annual election period, including handling incoming calls from medicare preferred members, quoting benefits, describing plan information and premiums, and advising on plan changes.

         expertly employed use of macess, diamond, ccms, peoplesafe, and microsoft office software.

 

customer service representative cigna healthcare

         strategically steered customer support activities during cigna s medicare access open enrollment period, including liaising between members, providers, and agents, as well as quoting benefits, providing claim status, delivering enrollment information, and placing outbound calls to members for critical enrollment verification.

         applied strong knowledge of qnxt, epitome, and cms website to support successful insurance operations.

 

 

provider customer service representative national bluecard (2009)

         contributed solid communication skills toward providing high-quality customer service for national bluecard, including overseeing claim status and working with member home plans to resolve claims issues.

         optimized organizational efficiency via expert use of callcare browser, wgs mainframe, and blue squared.

 

reconciliation analyst anthem colorado (2008)

         contracted to analyze and reconcile eligibility issues for medicare part d enrollments, including ensuring compliance with medicare guidelines while researching member eligibility and enrollment status and providing solutions to enrollment issues, as well as using recon, wgs mainframe, marx (cms), and sms.

 

customer service representative blue cross blue shield (2006 c 2007)

         provided key customer service for members and providers, including performing within a team-oriented call center, as well as working on-site for anthem blue cross in connecticut and blue cross blue shield in florida.

 

 

customer service representative

         played a vital role in building and sustaining productive operations by providing integral customer support for hoosier healthwise and indiana medicaid, including maintaining responsibility for member education and doctor selections, as well as working as part of a call center team for americhoice, a united healthcare company.

 

 

customer care assistant

         demonstrated customer service excellence by providing support for members of priority partners, a medicaid hmo for the state of maryland, including quoting benefits and claim status for providers and members.

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resume page two • (xxx-xxx-xxxx • abc@xyz.com

 

professional synopsis (continued)

 

 

technical support representative

         led solutions-focused technical support and customer service for verizon dsl internet subscribers, including promptly responding to and resolving varied hardware, software, and internet connectivity challenges, as well as resourcefully explaining it situations and terms to assist customers without prior computer knowledge.

         multitasked among numerous computer programs simultaneously to provide accurate it assessments.

 

 

customer service representative

         delivered comprehensive information for anthem individual insurance customers and medicare recipients, including corresponding via telephone and written letter, researching complex or special cases to follow up and guarantee customer satisfaction, and analyze pharmaceutical and medical claims to determine payment issues.

 

additional professional roles held prior to 2002

 

education & technical summary

 

bachelor of arts in telecommunications                                                                            indiana university at bloomington

 

microsoft office • macess • diamond • ccms • peoplesafe • qnxt • epitome

cms • callcare browser • wgs mainframe • blue squared • recon • marx • sms