Customer Service Call Center

Fatima Umbashi

*************@*****.*** 916-***-**** Sacramento, CA

SUMMARY

Seeking a Claims Processor role with 7 years of experience in claims processing and customer service. Proficient in bilingual support (Arabic/English), eligibility verification, and providing actionable feedback to enhance service quality. Excelled in processing unemployment and medical claims, ensuring compliance and effective communication with clients and providers.

WORK EXPERIENCE

Maximus (Randstad Staffing Contract) Folsom, CA

Claim Processor Apr 2022 - Jan 2023

• Processed unemployment claims efficiently, adhering strictly to company policies and procedures to maintain a compliant and professional work environment.

• Delivered basic technical support to clients, ensuring effective resolution of issues with a variety of company products.

• Analyzed customer satisfaction data and provided actionable recommendations to enhance service quality and business operations.

Gainwell Technologies/DXC/Conduent Call Center Sacramento, CA Claims Processor Oct 2018 - Apr 2022

• Addressed bilingual clients' inquiries and concerns regarding billing and eligibility, leveraging Arabic fluency to enhance communication and service quality.

• Verified and processed client eligibility for medical services, conducted thorough investigations into billing discrepancies, and ensured accurate referrals for various medical procedures.

• Communicated effectively with clients and providers, delivering clear explanations on denied claims and coordinating resolution efforts for outstanding issues.

• Successfully completed the credentialing of 5-10 Providers with Medi-Cal, meticulously collecting and verifying essential documentation.

Faneuil Call Center Hampton, VA

Part-Time Customer Service Representative Oct 2016 - Mar 2018

• Delivered comprehensive customer service, ensuring accurate and efficient data entry, case processing, and document verification for manual review.

• Facilitated seamless inbound and outbound communication, maintaining a high standard of empathy and courtesy in client interactions.

Maximus (Apple One Staffing Contract) Folsom, CA

Part-Time Claims Processor Oct 2016 - Mar 2018

• Processed claims and enrolled medical recipients in Managed Care Plans, ensuring accurate eligibility verification and adherence to customer service standards.

• Provided bilingual support by translating calls between English and Arabic, contributing to enhanced communication and customer satisfaction.

A.C.T. Call Center Folsom, CA

Customer Service Representative Feb 2015 - Aug 2017

• Collaborated effectively with team members to maintain high productivity levels and support organizational objectives.

• Managed quality control processes for data entry and insurance claim handling, ensuring accuracy and timely completion of tasks.

• Delivered bilingual customer support in Arabic and English, facilitating clear communication and efficient resolution of customer issues.

EDUCATION

Sacramento Job Corps

GED

Sacramento, CA

2005

SKILLS

Customer Service • Technical Support • Claims Management • Time Management • Data Analysis • Problem-Solving

• Bilingual (English/Arabic) • Record Keeping • Conflict Resolution • Client Relations • Medical Authorizations • Compliance • Process Improvement • Cross-Functional Collaboration

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