Health Insurance Customer Service Representative
Resume:
RYAN
A.
WILLIAMS
****************@*****.***
Kinnelon, NJ ZIP_US
Customer Service Representative specializing in health insurance support, member issue resolution, and benefit explanation. Handles 5– 10 escalated cases per week with calm, accurate follow-through while explaining 13–25 claims or coverage questions per day across fast- moving healthcare workflows. Strengthens member satisfaction through clear communication, training support, and timely resolution of claims and coverage questions.
PROFESSIONAL SUMMARY
Patient Access Operations
Client Support Operations
SKILLS
• Patient coordination
• Insurance verification
• Appointment scheduling
• HIPAA compliance
• Records management
• EHR documentation
• Medical terminology
• Payer communication
• Referral coordination
• Prior authorization
• Customer service excellence
• Front-office operations
• Claims follow-up
• Multiline phone systems
• Patient intake support
• Patient registration
• Benefit explanation
• Denial resolution
• Patient portal support
• Medical records release
Leaders For Life Academy
EDUCATION
Horizon FEP Program - Customer Service Representative Newark, NJ • 08/2024 - 06/2026
Summit Medical - Patient Coordinator
Berkeley Heights, NJ • 02/2021 - 09/2024
Sodexo - Lounge Attendant
Newark, NJ • 04/2019 - 02/2021
PROFESSIONAL EXPERIENCE
Managed escalated member issues with composure, ensuring timely and accurate resolutions aligned with Federal Employee Program guidelines.
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Provided clear, empathetic support by explaining benefits, coverage details, and claims processes.
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Collaborated with internal teams to streamline service delivery and improve response efficiency.
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Trained new representatives on customer service protocols, system navigation, and communication standards.
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Strengthened member satisfaction through consistent follow-through and high-quality service interactions.
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Delivered a welcoming, efficient front-office experience by greeting patients, managing check-ins, and coordinating appointment scheduling.
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Verified insurance coverage, processed payments, and ensured accurate financial and demographic data.
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Maintained HIPAA-compliant patient records, improving documentation accuracy and reducing administrative delays.
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Resolved patient questions and concerns with professionalism, contributing to higher satisfaction and smoother clinic operations.
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Partnered with clinical staff to optimize patient flow and reduce wait times.
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Executed filing, chart preparation, and data entry tasks that strengthened overall office organization.
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Delivered exceptional guest service by anticipating needs, fulfilling requests promptly, and maintaining a polished lounge environment.
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Newark, NJ • 08/2024
High School Diploma
Crane's Mill - Hospital Food Service Worker
West Caldwell, NJ • 10/2018 - 04/2019
Essex Valley Spine & Health Care - Medical Receptionist East Orange, NJ • 04/2018 - 11/2018
Managed inventory, restocked supplies, and ensured product availability.
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• Processed cash and card transactions with accuracy. Enhanced guest experience by resolving inquiries and maintaining a friendly, professional atmosphere.
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Prepared and delivered meals tailored to patient dietary restrictions, improving nutritional compliance and satisfaction.
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Coordinated with nursing and care teams to ensure timely meal delivery.
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Maintained strict food safety standards and adjusted preparation processes to meet dietary guidelines.
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Managed multi-line phone systems to schedule appointments and support patient inquiries.
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Escorted patients to exam rooms, contributing to a welcoming clinical environment.
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Organized and safeguarded confidential medical documents in compliance with HIPAA.
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English — Native
LANGUAGES
Available upon request
REFERENCES
Contact this candidate