Customer Care Representative - Claims & Verification

CNAWA JONES

Gray, LA • 985-***-**** • *********@*****.***

CUSTOMER CARE REPRESENTATIVE

10+ years of experience handling high-volume customer inquiries, resolving service issues, processing account requests, and maintaining accurate records. Skilled in phone, email, and system-based support with strong documentation, problem-solving, and ownership of customer concerns. Known for clear communication, fast issue resolution, and consistent performance in service-driven environments. CORE SKILLS

Customer Care • Call Handling • Email Support • Complaint Resolution • Refund Processing Account Updates • Registration Support • Documentation & Recordkeeping • CRM Systems Multi-System Navigation • Problem Solving • Communication • Microsoft Office • Compliance PROFESSIONAL EXPERIENCE

Conduent Business Solutions — Post-Sales & Claims Specialist 2025–2026

• Answered inbound customer inquiries via phone and email regarding services, claims, and account issues.

• Tracked and documented all customer interactions, complaints, and resolutions in CRM systems.

• Researched issues across multiple systems to assess complaint validity and determine solutions.

• Issued refund requests and communicated adjustments or investigation results to customers.

• Collaborated with leadership on escalated concerns requiring additional review.

• Provided accurate information on new services and programs while processing incoming calls. Nelnet Diversified Solutions — Customer Verification & Claims Specialist 2020–2025

• Responded to customer inquiries regarding eligibility, claims, and account documentation.

• Recorded detailed notes on customer interactions, complaints, and follow-up actions.

• Processed adjustments, refunds, and claim status updates with accuracy and compliance.

• Contacted customers to provide investigation results and next steps.

• Assisted customers with registration, documentation, and program requirements. The Home Depot — Credit & Verification Associate 2018–2020

• Handled customer account questions, credit applications, and service concerns.

• Resolved billing issues and processed account updates.

• Communicated charges and program details clearly to customers.

• Recognized as Cashier of the Year for accuracy, service quality, and customer satisfaction. Boost Mobile — Store Manager / Sales Lead 2009–2018

• Managed customer accounts, service complaints, and billing discrepancies.

• Contacted customers to resolve issues and provide updates on investigations.

• Increased store performance by 47% through improved customer care and retention.

• Trained staff on complaint handling, documentation, and service recovery. VOLUNTEER EXPERIENCE

Council On Aging — Medicaid Application Assistant

• Assisted individuals with application completion, documentation, and eligibility questions.

• Maintained accurate records and ensured confidentiality of sensitive information. TECHNICAL SKILLS

CRM Systems • Citrix • Cisco Jabber • Microsoft Excel • Outlook • Word • Google Workspace • Windows

EDUCATION & CERTIFICATIONS

High School Diploma Medical Terminology (In Progress) Medical Claims Adjudication (In Progress)

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