Business Process Customer Service

Jennifer Jones

* *********** ****

Covington Township PA 18424

570-***-**** cell

ad25oa@r.postjobfree.com

Education

Capella University – 2018

Bachelors of Science, Business, Specialization in Healthcare Management

Honors Summa Cum Laude

Delta Mu Delta

McCann School of Business – 2012 Computer Office Support Certificate

Experience

CIGNA Healthcare Oct. 2006 – present, Moosic/ Remote

Account Receivable Manager April 2019-Current

Initiate and manage end-to-end service operations and relationship across a

national ancillary segment for all escalated claim issues.

Handles high priority issues within assigned segment and manages claims for

timeliness and accuracy, proactive monitoring of claims, utilizing and leveraging

robust knowledge of claims processing, and available tools and resources to

properly manage partner accounts.

Create and maintain robust relationships with matrix partners to resolve issues

in order to manage a timely Accounts Receivable.

Executes all daily assigned activities, functions, and business process

improvements as Project Subject Matter Expert (SME).

Supports business process improvement initiatives through identification and

support of business process improvement opportunities.

Utilizes strong analytical and problem solving skills to analyze issues for root

causes, initiate and manage appropriate Cigna programs, policies, procedures,

and strategies to successfully resolve outstanding claims and provide support

with matrix partners.

Achieve service goals and objective as expected by direct manager.

Ensures timely execution of compliance with CIGNA standards in assigned

segment by leveraging excellent organizational skills.

Proven ability to utilize resources, prioritize, manage and meet deadlines.

Robust understanding of medical insurance products.

Claim Processor/ SME April 2012 – April 2019 (Cigna)

Subject Matter Expert (SME) demonstrating mastery knowledge and the ability

to service, train and influence new hires.

Customer Service Representative/ Trainer October 2006 – March 2012 (Cigna)

Utilized active listening skills to improve the customer experience.

Resolved outstanding customer service issues utilizing strong analytical and

problem solving skills relating to eligibility, claims, benefits and miscellaneous

issues for insured persons for the Open Call (unresolved issues) team.

Cashier/Waitress Oct. 2005 – Oct. 2006 Donut Connection Clarks Summit

Maintained a balanced register and cash transactions for services.

Provided service to customers in a timely, friendly manner.

Machine Feeder June 2003 – Jan. 2004 Scranton Times Distribution Center

Refilled insert machines for daily and Sunday Paper.

Assistant Manager/Researcher Feb. 2001 – May 2002 Gore/Knauff Research Co. Clarksville, TN

Supervised 4 employees.

Administered computerized research surveys consumer opinions.

Responsible for employee scheduling.

Set up and troubleshooting of proprietary computer programs.

Served as a liaison between employees and management.

Assistant Manager Jun. 1999 - Jan. 2001 Mancino’s Clarksville, TN.

Supervised 8 employees, and 2 locations.

Balanced register receipts and nightly deposits.

Certified Nurse’s Aide/Restorative Aide June 95 - April 99 Greenridge Nursing Home Scranton, PA

Managed the Restorative Care Program.

Help create and implement programs to better assist patients in their recovery.

Worked with patients on maintaining daily routine.

Helped train family on how to assist patients upon discharge from facility.

Worked with Physical and Occupational Therapist.

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