Customer Service Representative

Terrie Small

**** ****** **.

Detroit, MI ***** Home: 313-***-****

Email: *****.******@*****.*** Cellular: 313-***-****

Summary of Qualifications

A dynamic, team-spirited, and result-oriented professional with strong organizational, communication and

analytical skills. Creative, detail-oriented, and highly dependable; work effectively in stress/high pressure

situations; flexible and adaptable to change. An innate ability to easily interface between both management and

staff as well as with individuals of diverse backgrounds and cultures.

Professional Experience

SUMMIT HEALTH (CONTRACT), Novi, MI, September 2014 to December 2014

DATA INTREGRITY SPECIALIST, Performed detailed analytical research using Excel to perform analysis,

resolve problems and discrepancies related to claims data and databases. Cleaned and analyzed participants’

data files for flu and wellness events. Secured file transfer protocols and upload requirements of data.

Maintained databases for eligibility/enrollment files. Ensured accuracy, timeliness and overall integrity of Summit

Health.

IRON MOUNTAIN (CONTRACT), Canton, MI, June 2014 to August 2014

DATA ENTRY SPECIALIST, Managed a centralized database for active and inactive records using Accutrac

and Safekeeper through classification, indexing, retention and overall cost reduction in storing and managing

records. Performed all work in accordance with record management work practices and procedures. Ensured

the accuracy and relevancy of all data entered into databases.

BLUE CROSS BLUE SHIELD OF MICHIGAN (CONTRACT), Bingham Farms, MI, February 2013 to December

2013

BENEFIT ANALYST, Reviewed, interpreted, configured and loaded group benefits. Delivered assistance,

coordination and follow-up on complex problems and ensured resolutions. Communicated plan benefits and

changes effectively. Conducted systems requirement assessment in support of regulatory changes. Attained

several internal NASCO on-line training with certificate of completion.

MOLINA HEALTHCARE OF MICHIGAN, Troy, Michigan, December 2012 to January 2013

MEMBER SERVICE REPRESENTATIVE, Responded accurately and professionally to member and provider inquiries

regarding benefit interpretation, eligibility and claims status. Handled escalated complaints from Members,

Pharmacies, and Providers by investigating the complaints and providing timely responses and/or resolutions to

them. Reviewed, modified as necessary, and re-billed rejected/denied Medicaid and Medicare claims. Handled

all claim edits appropriately including possible duplicates, eligibility status and corrected bills.

METLIFE INSURANCE (CONTRACT), Southfield, Michigan, April 2012 to November 2012

GROUP LIFE ADMINISTRATOR, Provided assistance to claimants via telephone regarding eligibility, claim

processes and procedures. Assisted with claims set up, researched complex claims and policy coding issues

and documentation retrieval. Responded to written and/or telephone inquiries from employees, beneficiaries,

attorneys and families of deceased employees.

ACS (CONTRACT), Allen Park, Michigan, August 2011 to October 2011

BENEFITS REPRESENTATIVE

Administered health and welfare plans including enrollments, terminations and changes. Provided customer

service to employees, retirees, and VEBA participants by answering benefit questions, resolved issues and

educated callers on benefits elections and changes. Received extensive training with VEBA, Medicare and

employee’s benefits.

MEADOWBROOK INSURANCE GROUP, Southfield, Michigan, January 2008 to July 2010

CUSTOMER SERVICE REPRESENTATIVE, Provided administrative expertise to large commercial accounts

with respect to account billing, policy evaluations and distribution, reports, and benchmarking. Mediated

insurance sales and quotes, developed proposals; and gathered supporting documentation for underwriting

decisions. Reduced backlog of policy checking within 4 months.

TITAN INSURANCE, Troy, Michigan, February 2006 to January 2008

SENIOR POLICY SERVICE REPRESENTATIVE, Responded to a high volume of calls promptly, this included

promoting enduring relationships with a diverse clientele, internally and externally. Exceeded company’s stretch

target of 95% within the 1st three months; and commended by management for consistently meeting objectives.

Analyzed and resolved discrepancies through the use of diplomacy and effective problem solving,

communication and interpersonal skills.

ACG LIFE SALES AGENCY, Dearborn, Michigan, April 2005 to July 2005

CASE MANAGEMENT ASSOCIATE, Provided consistent, effective and proactive administrative to support to a

group of sales agents. Collected vital and confidential information, updated clients on policy status, explained

discrepancies and/or processes. Handled a large volume of policies and delivery requirements in a time sensitive

manner; processed and reviewed documentation in a fast-paced environment.

AAA LIFE INSURANCE COMPANY, Livonia, Michigan, December 2003 to April 2005

CUSTOMER SERVICE ASSISTANT, Provided quality service in a high volume call center. Processed policy

changes; policy loans and dividends; surrenders; 1035 exchanges; conversions; and produced enforced

illustrations. Demonstrated knowledge and capabilities to assist customers with their needs in a timely and

efficient manner.

Education and Licenses

CENTRAL MICHIGAN UNIVERSITY, Master of Science in Health Services Administration, 2013

DAVENPORT UNIVERSITY, Bachelors of Business Administration, 2004

WAYNE COUNTY COMMUNITY COLLEGE, Associates of Arts, 1998

Computer Skills and Training: Windows, Microsoft Suite (Excel, Access, Word and Powerpoint), AMS, Lotus

Notes, AS/400, Outlook, Internet Explorer, SAP, QNXT, CHAMPS, Benefit Editor, Benefit Configurator, Document

Editor, SharePoint, PeopleSoft, Kronos, NASCO, DCS, APEX, Safekeepers, Accutrac

References Furnished upon Request

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