Customer Service Sales
Resume:
Sandra Jackson
**** ***** ******, ******, ** ****4
E-mail: *****@*********.***
Job Objective:
CLAIM EXAMINER, CLIENT SERVICES - CUSTOMER SERVICE
Experience:
Job Title
Senior Customer Service Associate
Employer
Cigna
Dates
10/08 to present
Duties
Respond to inquiries via phone, mail, e-mail, and in-person from policy holders,
providers, and others for information and assistance regarding medical coverage
and claims. Interprets plans and policies for resolution of inquiries.
Job Title:
Claims Examiner
Employer:
Octagon Risk Services, Oakland, CA
Dates:
6/05 to 11/06
Duties:
Analyzed, processed and adjudicated claims making claim decisions based on
thorough investigations and by interpreting and applying applicable laws, codes,
administrative rules, regulations, guidelines, and policies and procedures.
Evaluated and determined appropriate payments and benefits. Negotiated
cost-effective settlements.
Job Title:
Benefit Analyst
Employer:
Genworth Financial, San Rafael, CA
Dates:
6/04 to 01/05
Duties:
Analyst assigned to long term care caseload to objectively adjudicate complex
long term care claims. Processed daily benefit payments and claim queues.
Job Title:
Claims Examiner/Associate Examiner/Claims Assistant
Employer:
Kaiser Foundation Health Plan, Oakland, CA
Dates:
01/91 to 05/04
Duties:
Analyzed claims for claim decisions and determinations based on thorough
investigations and by applying applicable laws, administrative rules, and
guidelines. Evaluated claims for payment of appropriate benefits. Analyzed claims
for cost-effective settlements and negotiated settlements.
Job Title:
Customer Service Rep
Employer:
Pacific Bell, Berkeley, CA
Dates:
9/88 to 6/90
Duties:
Service Representative in high volume call center assisting customers with orders
and billing related services. Recommended, sold, and promoted products and
services.
Skills:
CLAIMS ANALYSIS, CLIENT AND CUSTOMER SERVICE, MEDICAL TERMINOLOGY, MATH INCLUDING
COMPLEX FORMLAS, DATA ENTRY, TYPING, COMPUTER LITERATE, ANALYTICAL AND
INTERPRETIVE, PROBLEM SOLVING, NEGOTIATOR, SALES, COMMUNICATION, RECORD
MANAGEMENT, BOOKKEEPING, FILING, COPYING, FAXING, SCANNING, MAIL, AND
RECEPTIONIST.
Education:
Some College and Claims Certificate
Contact this candidate