Customer Service & Claims Specialist Resume Title
Resume:
Rachel Olmos
Surprise, AZ **387
******.*******@*****.***
Summary of Skills
Customer Service
Operate telephone switchboard to answer, screen and forward calls, providing information, and taking messages.
Confer with customers by telephone or in person to provide information about products and services, to take or enter orders, cancel accounts, or to obtain details of complaints.
Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
Determine charges for services requested, collect deposits or payments, or arrange for billing.
Identifies, understands and interprets customers' needs to billing resolutions.
Receive payment Andy record receipts for services.
Resolved customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, and adjusting bills.
Data Entry
Analyze financial data to detect irregularities in areas such as billing trends, financial relationships, and regulatory compliance procedures.
Compare data with source documents, or re-enter data in verification format to detect errors.
Compile, sort and verify the accuracy of data before it is entered.
Conduct in-depth investigations of suspicious financial activity, such as automatic teller machines /debit cards.
Create and maintain logs, records, or databases of information about fraudulent activity.
Read source documents such as canceled checks, sales reports, or bills, and enter data in specific data fields or onto tapes or disks for subsequent entry, using keyboards or scanners.
Store complete documents in the appropriate location.
Claims Processors, in general, responsible for examining and processing health insurance claims according to established guidelines and regulations. My duties typically include verifying claim information, making payment decisions, and resolving any issues that arise with the claims process.
Experience:
Blue cross Blue shield of Arizona
February 2020-present
Skills and Qualities: Attention to Detail: Accuracy is crucial when examining and processing claims. Analytical Skills: Ability to review and analyze claim information to make informed decisions. Problem-Solving Skills: Ability to identify and resolve issues that may arise during the claims process. Communication Skills: Ability to communicate effectively with members, providers, and other stakeholders. Computer Skills: Proficiency in using various computer systems and software related to claims processing. Knowledge of Healthcare Terminology:Understanding medical terminology and codes is essential for accurate claims
Uber
October 2018 - January 2020
Rider Claims/ White glove service
I received email from riders about issues with the ride they took. Investigate claims using maps to see how far and how long the ride took. Making an outbound call to collect more information about what was the issue with the ride. I also gave credits to the rider if the driver was at fault. By adjusting the amount of the collected amount for the ride. I would give full refunds to the customer. Unpair rider with driver so they would have that driver pick them up again. Also send drivers to the safety department to complete classes. I would complete the claim within 1 hour. I would take an estimate of 45 inbound calls while completing Web-chat as well.
Waste Management
August 2016-October 2018
Customer Service
Receives 80+ inbound calls
I set up new accounts for new customers to have trash picked up.I took payments, adjusted payments, gave credits and scheduled pick ups of containers. I would set up tickets for missed pickup, swap cans and container deliveries. Also set up appointments for bulk pickups of containers. I would reverse payments and give credits to accounts for missed pick ups of trash.
Looked up payments to see where they went and made sure it went to the right account. Order containers for new customers through web-chat and email.
Winco Warehouse
November 2010-July 2016
Check in Clerk
Typical Duties and ResponsibilitiesSchedule inbound Freight delivery appointments for common carriers delivering product to the warehouse. Utilize a computerized schedule grid, input appointment times, purchase order number and carrier.Track daily arrivals of common carriers, identify issues such as late arrivals or missed appointments. Print scheduled purchase orders and receiving license plates for each scheduled appointment, organize and prepare the documents for distribution to warehouse receivers. Check in common carrier truck drivers before they unload; verify the Bill of Lading matches up with purchase orders. Process completed paperwork provided by the receiver, matching the purchase order with the invoice and forwarding documents to the accounts payable office. Organize and prepare store order pick lists; sort and batch by order reference number for distribution to order pickers, include a tag that provides the dock door assignment based on order routes provided by dispatch. Print load control documents; provide copy to loading department for cross-reference as orders are loaded onto outbound trailers for store deliveries. Perform other duties as assigned or needed
Bank of America
January 2005-April 2010
Fraud Analyst 2
Took 90+ Fraud calls for fraud Business and Military credit cards.
Set up new account for fraudulent Business and Military credit cards.
Investigated accts for Fraud.
Cancel accts with potential fraud.
Handles 100+ calls per day. (AHT 230 Secs per call.)
Set claims for fraud accts for investigations.
Mailed/Emailed affidavit.
Removed block on accts with no fraud.
Education
HS: Phoenix College, Phoenix, AZ
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