Customer Service Representative

Larry Graham

** ******** **** ******, ** ***** Phone: 301-***-**** Email: *************@*****.***

Health Insurance Industry Professional

Client Relations Document Management Insurance Claims

Goal-driven and dedicated customer service administrator with extensive health insurance and financial industry

Experience specializing in customer relations, claims management, document tracking, and complex problem

solving. Detail-oriented with excellent leadership, interpersonal, and verbal and written communication skills.

Equipped with excellent work ethic; recognized for efficiency, commitment to team collaborations, and ability to

complete projects on time with high quality standards.

Technical Proficiencies: Microsoft Word and Excel, Lotus Approach, Internet Explorer.

Language Skills: Bilingual fluency in Spanish and English; ability to speak, read, and write at an advanced level.

AREAS OF EXPERTISE

Medical Insurance

Insurance Claims

Complex Problem Solving

Customer Service

Document Tracking

Prioritization

Confidentiality

Data Entry

Administrative Skills

Account Management

Team Collaborations

Time Management

PROFESSIONAL EXPERIENCE

Member Service Representative: Celticare Health Plan, Boston, MA October 2010 to March 2015

Process Primary Care Physician changes for members and providers, providing excellent customer service in every encounter.

Respond to inquiries from members and providers regarding health insurance and claim disposition.

Member Service Representative: Tufts Health Plan, Boston, MA May 2010 to June 2010

Provided customer services, responded to claim inquiries, and offered issue resolution.

Customer Service Associate: Pitney Bowes, Washington, DC July 2008 to October 2009

Answered phone calls at the customer service counter while simultaneously handling student inquiries concerning mail and package requests in person.

Received a Customer Service Award by the President of George Washington University for providing resolution to customer complaint calls.

Document Tracking Specialist: Chevy Chase Bank, Bethesda, MD November 2000 to November 2007

Contributed expertise to the Mortgage/Home Loan department working on 80-100 files per day.

Assisted the Lien Release Specialist in releasing liens on paid off Home Equity loans from California and Virginia.

Analyzed and ensured company legal files contained all relevant information including recorded deeds of trust and promissory notes.

Contacted courthouses and attorneys in California and Virginia to verify that all deeds of trust were properly recorded with the appropriate courthouse.

Entered data into the Lotus Approach system, reconciled payoff report inventory, prepared lien status reports, assisted in company file room maintenance, and distributed company mail.

Larry Graham – Page 2

Phone: 301-***-**** Email: *************@*****.***

Member Service Representative: Kaiser Permanente, Silver Spring, MD October 1999 to July 2000

Positioned company for progressive success as key liaison between members and the management team; located doctors and medical services/facilities within the network for members.

Helped members understand their insurance coverage such as whether or not a procedure was covered, out of-pocket expense amount due, and explained benefits and deductible responsibility level.

Maintained follow up on assigned member accounts resulting in higher loyalty, satisfaction and retention levels; demonstrated exemplary abilities in resolving complex issues with difficult members.

Customer Service Representative: Seabury & Smith, Washington, DC September 1998 to October 1999

Interacted effectively with all members, provided world class customer service, and projected and maintained a positive and professional image as a reflection of the overall organization.

Awarded for consistently meeting goal of handling 100 calls per day to explain health insurance benefits to members from various associations.

EDUCATION

Bachelor of Arts Degree in Hispanic Studies Language

Connecticut College, New London, CT

Paralegal Certification

Northeastern University, Boston, MA

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