Operations Support Specialist - Claims & Help Desk

DANIELLE DORSEY

Arlington, TX 682-***-**** ***************@******.***

PROFESSIONAL SUMMARY

Versatile and detail-oriented operations support professional with over 10 years of experience spanning customer service, healthcare claims administration, system troubleshooting, and high-volume data management. Proven track record of high performance, including maintaining a 95% First-Call Resolution rate and managing zero-error corporate databases. Skilled at bridging technical support with exceptional client care, adhering to HIPAA compliance, and collaborating across teams to deliver efficient, high-quality outcomes.

CORE STRENGTHS

• Customer Service & Support: Multi-channel support (Phone, Email, Live Chat), Complaint Resolution, Executive Support

• Technical Support & Systems: Tier 1 Help Desk, Ticket Lifecycle Management, System Testing, Access/Bug Escalations

• Healthcare & Claims Admin: Disability Claims, Leave of Absence Benefits, Medical Billing, Provider Profiles, HIPAA Rules

• Software Programs: FACETS, COSMOS, Microsoft Office Suite (Excel, Word, Outlook), Remote Databases

• Data & Operations: High-Speed Data Entry, Database Auditing, Digital Record Archiving, Quality Assurance WORK EXPERIENCE

Care Team Representative — Sedgwick July 2025 – June 2026 Hybrid Managed high-volume inbound calls regarding short-term disability and leave of absence benefits with care and accuracy.

Documented detailed customer interaction logs in central databases while maintaining strict adherence to HIPAA guidelines.

Researched client accounts to explain specific insurance benefits, clarify claim statuses, and answer member inquiries. Navigated multiple software applications simultaneously to look up files and process customer requests efficiently. Collaborated with team leads and leadership to speed up claims processing and improve overall customer satisfaction. Office Professional — Southern Hospitality Management October 2020 – June 2025 Remote Monitored and managed busy remote email and call queues, responding to executive-level requests promptly and professionally.

Maintained zero-error rates across corporate tracking databases using Microsoft Excel formulas to update vital business records.

Audited daily operational files and corporate paperwork to ensure full compliance with high internal standards. Operations Support Specialist — CalAmp August 2019 – September 2020 Hybrid Delivered Tier 1 technical support and operational assistance via phone, email, and live web chat. Investigated system errors and generated detailed technical logs to assist software engineering teams in patching bugs. Tracked open customer support tickets from initiation through final resolution within scheduled time frames. Data Entry Clerk — Pilot / Flying J January 2019 – March 2019 Lawton, OK Keyed massive amounts of everyday tracking and shipping records into main computer systems quickly and accurately. Scanned and digitized historical physical paper records into a searchable digital database to streamline file retrieval.

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Provider Data Specialist — UnitedHealth Group February 2016 – July 2018 Lawton, OK Managed medical provider profiles inside FACETS and COSMOS healthcare databases while protecting personal data under HIPAA.

Investigated profile data errors and worked directly with doctors' offices and internal insurance teams to fix billing issues. Shared user feedback and wrote simple summary reports for tech teams to help make database software easier for staff to use.

Customer Service & Claims Specialist — United Healthcare Student Resources

November 2014 – February 2016 Lawton, OK

Answered questions about medical insurance policies and claim status, maintaining a steady 95% first-call resolution rate.

Checked client histories across different health insurance platforms to resolve conflicting provider billing issues. Helped members log into the online dashboard, solved basic access blocks, and showed users how to read their plan benefits.

EDUCATION

Coursework in Cyber Security Tarrant County College — Arlington, TX High School Diploma Eisenhower High School — Lawton, OK (Graduated 2004)

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