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The Following Text Is An Unformatted Professional Resume Sample

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Yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000 804-349-5583


Summary of Qualifications


  Customer service professional with valuable, hands-on experience, including in the healthcare field.

  Strong understanding of the Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI), as well as Medicare and Medicaid.

  Solid knowledge of insurance eligibility and application processes, including making referrals to other agencies such as the Department of Social Services (DSS) and the Virginia Department of Health (VDH).

  Experience adhering to Virginia Department of Medical Assistance Service (DMAS) regulations and using MMIS and VaCMS software programs.

  Outstanding communication skills, including training team members on best practices of operations.

Professional Experience


Call Center Specialist, Xerox (hired via Whitenack Consulting) Dec. 2015-Apr. 2016

  Educated customers about their Form 1095-B tax form impacting healthcare coverage.

  Used a seven point verification method to meet HIPAA standards regarding PHI.

  Achieved an average handle time for calls of just seen minutes.

  Used MMIS, Oracle and VaCMS software to locate client information for correction or verification.

Telephone Representative, First Street May 2015-Dec. 2015

  Communicated effectively with callers regarding product use and procedure for home trials.

  Screened candidates and assisted callers with setting up accounts as well as maintaining their accounts.

  Processed payments in an accurate, timely and efficient manner.

  Consistently met call level and supervisor expectations on a monthly basis.


Mortgage Client Services Representative, SunTrust Bank (hired via Rose International) Dec. 2013-Mar. 2014

  Guided clients about preserving or modifying their existing loans.

  Educated clients about their escrow, payments, principal interest and taxes and ran payoff quotes.

  Processed customer transactions in an accurate, timely and efficient manner.

  Facilitated split payments from clients using Western Union Speed Pay.


Patient Support Specialist, JenCare Medical July 2012-May 2013

  Telephoned prospective patients inviting them to tour senior facilities hosted by the company.

  Helped to coordinate events and collected names, addresses, and phone information for follow-ups.

  Coordinated with personnel at Humana to verify insurance coverage and qualify patients for the Humana Gold Plus HMO Plan.


Member Services Representative, The Famis Program Apr. 2010-July 2012

  Processed medical service requests and ensured accuracy according to state standards.

  Provided detailed information about clients programs, policies and procedures.

  Met outlined benchmarks and/or quality indicators via audits or recordings.

Education and Training


Business and Clerical Certification Harpers Ferry, WV Job Corps

Completed Customer Care Training, SunTrust, as well as Training via TK Worldwide

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