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Yyyyyy x. yyyyyy

(INSERT NEW ADDRESS)

Phone: (xxx-xxx-xxxx abc@xyz.com

 

Client-focused professional with significant insurance industry background eager to

contribute exceptional administrative, organizational and interpersonal skills toward supporting a dynamic company in optimizing bottom-line performance.

 

Qualifications Profile

 

         Well-versed in employee benefits operations and administration, medical insurance claims, client relationship management, and office operations.

         Considerable talents in staff training, leadership, mentoring, coaching and supervision.

         Employ solid critical thinking skills to scrutinize challenges, propose modifications, and drive solution implementation; consistently focus on productivity and cost control.

         Strive to establish a collaborative climate across multiple departments and identify opportunities which will result in long-term benefits for the employer.  

         Outstanding prioritization, decision-making, organizational, and communication skills.

         Reputation for integrity, thoughtfulness and professionalism.

         Maintain confidentiality of files and documents, and develop highly productive employees.

 

Professional Experience

 

Universal Health Care Group, Jackson, MS, 2010 to Present

Member Services Representative

  • Expeditiously receive and process broad-scope customer calls with a constant eye on quality control and customer satisfaction.  
  • Serve as primary point of contact to analyze and swiftly resolve customer issues.

 

CoreSource, Inc. (a Trustmark Company), Wayne, PA, 2000 to 2010

Client Coordinator        (2006 to 2010)

         Applied strong communication, interpersonal and problem solving skills toward serving as liaison between CoreSource and third-party administrator for group medical benefits and clients.

         Facilitated cohesive efforts among multiple departments to expedite responses to client inquiries and achieve swift problem resolution.

         Assisted Client Managers to ensure delivery of top-notch service and attain 100% client satisfaction.

         Leveraged sharp administrative capabilities to generate reports, answer incoming calls, and prepare business correspondence.

         Actively participated in client implementations, benefit fairs, and open enrollment meetings. 

 

Medical Claims Department Team Leader         (2000 to 2006)

         Demonstrated exemplary leadership talents in training, supervising, motivating, mentoring and evaluating team of up to eight claims analysts.  

         Proactively investigated and resolved complex claim situations, vital to overcoming deficiencies, enforcing corporate and regulatory compliance, and attaining quality and quantity goals.

         Reviewed and processed subrogation/third party reimbursements for office.

         Monitored and ensured adequate phone coverage via IVR (interactive voice response) system.

         Maintained up-to-date file for PPO (Preferred Provider Organization) Network.

 

Education

 

B.A. in English, University of Alabama, Tuscaloosa, AL

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