Customer Service Medical

JEANNE KRANTZ

*** ******** ***** • Oswego, Illinois 60543

************@*****.*** • 630-***-****

SUMMARY OF QUALIFICATIONS

Versatile, insurance professional with diverse background in the health and life insurance industry, experience includes individual underwriting, appeal, claims adjudication, auditing, training and customer service. Excellent multi-tasking, interpersonal and communication skills, detail oriented with a strong work ethic.

Professional Experience

RSA Medical – Naperville, Illinois 2009 to 2012

Medical Underwriter

Reviewed initial application for individual health insurance for various insurance carriers.

Determined if additional medical information will be needed and ordering telephone

interviews and medical records.

Applied client’s guidelines and determined if an application can be issued standard,

modified or declined.

GUARDIAN LIFE INSURANCE – Chicago, Illinois 1999 to 2009

Sales Support Associate

Provided high-level administrative support to a top ten sales representative of leading provider of group insurance.

Provided support to 15 high producing brokers and 20 small producers

Performed a variety of key quoting functions, addressed inquiries of current and potential plan holders, communicated with underwriting department regarding rates, claim experience and necessary documentation.

Coordinated all documentation necessary to enroll new plan holders.

Created and maintained email mailing list of 1400 brokers. Sent out weekly emails informing brokers of new products and changes.

Designed instruction manuals and training sessions for various office procedures

UNITED HEALTHCARE – Naperville, Illinois 1987 to 1999

Senior Claims Processor

Served as Senior Claims Processor for many plan holders.

Managed greater than $100,000 hospital, surgical, and medical claims.

Entered medical claims based on the correct CPT code. Channeled necessary documentation to process claim accurately

Researched operative reports to determine if additional review by the medical department was warranted.

Reviewed correspondence from providers and employees regarding claims processed. Adjusted claims based on additional information or responded to correspondents regarding review determination.

Reported to state insurance inquiries on a timely basis.

Customer Service Representative for customers needing special attention.

Conducted training for new and current employees

EDUCATION

Aurora University, Aurora, IL,

Bachelor of Science, Computer Science, 05/95

Middle Management Degree 5/83

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