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Customer Service or Benefits Specialist Resume
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| Desired Industry: Insurance |
SpiderID: 14989 |
| Desired Job Location: Jacksonville, Florida |
Date Posted: 8/23/2007 |
| Type of Position: Full-Time Permanent |
Availability Date: 09/14/07 |
| Desired Wage: 33,000.00 |
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U.S. Work Authorization: Yes |
| Job Level: Experienced with over 2 years experience |
Willing to Travel: |
| Highest Degree Attained: Other |
Willing to Relocate: No |
Objective:
To obtain a challenging position utilizing my past experiences, while continuing to grow and learn new talents in a stimulating work environment.
Experience:
Blue Cross Blue Shield of Florida, Jacksonville, FL 07/06 to present
Customer Advocate- Employee Group
Answered customers’ telephone, written, and web inquiries their PPO, HMO, EPO, and Blue Options health insurance policies; assisted Blue Cross Blue Shield of Florida Employees during open enrollment with health and welfare benefits; applied medical coverage guidelines and contract benefits to support decision making process to ensure correct claims adjudication.
Biogen Idec 02/06 to 06/06
Customer Support Coordinator II, Raleigh, NC
Provided customer service support to patients and caregivers of patients diagnosed with Multiple Sclerosis; listened to and counseled patients and professionals regarding multiple sclerosis and how to use Avonex; interpreted professional and well-informed answers to their questions; supported doctor’s offices by contacting their Area Business Managers when additional marketing supplies were needed.
Fidelity Investments, Raleigh, NC 08/05 to 01/06
Business Analyst Associate
Provided Health and Welfare Operations support to IBM employees, retirees, and dependents. Health and Welfare subject matter expert for Medicare HMO policies; provided timely, accurate, and complete information to customers; investigated and resolved customer inquiries (including verbal as well as written inquires and responses); prepared and delivered subject matter training to Customer Service Associates; interacted on a regular basis with representatives from other internal organizations, carriers and vendors; provided support for IBM's annual enrollment cycle by providing Customer Service phone coverage; handled escalated work items, and other departmental projects as needed.
Blue Cross Blue Shield of Florida, Jacksonville, FL 10/97 to 08/01 and
Service Associate II 10/01 to 12/02
Answered customers telephone, written, and web inquiries their PPO, HMO, EPO, and Choice Model health insurance policies; assisted with training of new and seasoned employees within the unit; applied medical coverage guidelines and contract benefits to support decision making process to ensure correct claims adjudication; researched, investigated, and resolved special external provider issues with Project Consultants and Operational Effectiveness Analysts; processed reopen entry and suspense of HCFA-1500 and UB-92 claims; processed adjustments to make additional payments on claims; contact person for external providers with outstanding claims issues; quality Auditor for Training Application Unit Pilot Program; designated backup Senior Advisor and Subject Matter Expert; facilitated department meetings; assisted management with interviewing new applicants.
State of Florida- Department of Health-WIC Program 1995 to 1997
Cashier
Printed checks for clients; made referrals to social agencies for needed services; assisted the Nutritionist with assessing clients’ needs; balanced checks at the end of each day;
provided a monthly report of activities for the WIC Office; scheduled appointments for over 1000 monthly clients.
Education:
Six Sigma Yellow Belt- work in progress
Edward Waters College, Jacksonville, FL- Public Administration
St. Johns River Community College, Orange Park, FL - Associate of Arts Degree
Trinity Christian Academy, Jacksonville, FL
Skills:
10- key by touch; typing 50 WPM; copier, and facsimile; Microsoft Office 2003 Word, Excel, PowerPoint, Outlook 2003, Lotus Notes, Siebel, Client Letter, eSP, Lucent CentreVu, Diamond.
Candidate Contact Information:
| Name: Mary Bell |
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| Street: |
Phone: 904-213-8729 |
| City: Orange Park |
Fax: - |
| State: Florida |
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| Zip: 32073 |
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| Web Site: |
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