My Resume

Martin C. Benson

**** *. **** ***** # **

Sacramento CA. 95826

Cell: 916-***-****

E-mail: *************@*****.***

RELEVANT

SKILLS

Ten years of results-oriented experience, including:

• Call Center Multitasking

• Personnel Training

• Computerized Customer Service

• Customer Case Research

• Database Access/Updates

• Caller Education

EXPERIENCE

2006 – 2006 BRMS, Rancho Cordova, CA

Customer Care Representative

In a high volume call center environment, handled calls from medical service providers, active employees, COBRA participants, retired members, and brokers of self-insured PPO & POS Group health plans, in regards to eligibility, benefits, service authorizations, claim status, appeals, etc. Educated callers on policy and procedures, meeting or exceeding established performance goals on all the above in reference to call work, call volume, quality assurance and average hold time. Researched complex issues regarding claims and eligibility, account status and prior coverage. Updated demographic information, routed requests for check tracers and fulfilled requests for EOBs and HIPAA certificates to be sent to authorized parties. Performed additional duties as needed.

2006 – 2006 Superior Staffing, Sacramento, CA

Customer Service Representative

Handled calls from present and prospective customers in reference to all facets of cellular service, including billing, credit checks, service and equipment upgrades, etc., in a high volume call center environment utilizing a Windows-based computer system for request fulfillment and necessary product and account research. In addition, processed new order and service upgrade requests submitted via the Internet. Verizon Wireless - Folsom, CA.

2005 – 2005 Jacobson Solutions, Chicago, IL

Customer Service Representative

Serviced calls from network and non-network medical, hospital, and allied health providers in reference to status of submitted professional and facility claims. Performed requested research on specific claims, corresponding with member/patient insurance carrier to verify eligibility and benefits, authorizations and referrals, provider’s contract status and reimbursement rates for services rendered. Additionally, sent claims for reprocessing and adjustments when necessary. Anthem Blue Cross/Blue Shield-North Haven, CT.

EXPERIENCE

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2003 – 2004

Western Health Advantage, Sacramento, CA

Member Services Representative

Serviced calls from members and providers to verify/confirm eligibility and benefits, educating callers on HMO plan, policies, and procedures according to contract. Researched and resolved claims and billing issues, escalated requests for appeals and grievances, and fulfilled authorized requests for member materials.

2003 – 2003

NCO Benefit Systems, Horsham, PA

Customer Service Representative

Serviced calls from COBRA/Direct Bill participants, HR representatives from the previous employer, health care companies and providers in regards to coverage, systemic processes, and billing/premium accounting records for post-employment continuation of health care benefits.

2002 – 2002

ADECCO, Horsham, PA.

Customer Service Representative

Served in various customer support capacities at client locations in high volume call centers. AARP Pharmacy Services- Horsham, PA; Aetna US Healthcare- Blue Bell, PA.

1999 – 2000 Fleet Credit Card Services, Horsham, PA

Customer Service Representative

Provided prompt, courteous, and knowledgeable service for cardholder inquires using a Windows-based computer system in a high volume call center.

1997 – 1999

Keystone Health Plan East, Philadelphia, PA

Member Services Representative

Assisted members with claim submission and status explaining rights, responsibilities, and benefits according to type of contract. Updated database information with regard to member emergency services, changes of primary care physician/dentist, and demographics. Ordered member information sources and participated in special projects.

MILITARY United States Army, 1987-1989

United States Air Force, 1981-1984

EDUCATION Overbrook High School, Philadelphia, PA

Diploma awarded, 1978

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