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Claims Analyst Resume

PROFESSIONAL EXPERIENCE

Confidential

Claims Analyst

Responsibilities:

  • Review members plan to determine eligibility for services.
  • Document CRM system with all interactions.
  • Communicate with providers and inform them of eligibility and benefits.
  • Inform members and providers of reason for denial of claims.
  • Provide excellent customer service while assisting providers and members.
  • Detect errors made on claims and send for reprocessing.
  • Utilize resources and analytics to determine solution to problems.

Confidential

Member Services Analyst

Responsibilities:

  • Managed calls from members within the member experience umbrella.
  • Documented CRM system with all interactions.
  • Identified and accessed members needs to achieve satisfaction.
  • Built sustainable relationships and trust with members through open and interactive communication.
  • Provided accurate, valid and complete information by using the right methods and resources.

Confidential

Administrative Assistant

Responsibilities:

  • Provided excellent customer service.
  • Managed inventory of assets and supplies.
  • Sent out and received mail and packages.
  • Performed multifaceted general office support.
  • Conducted precise and accurate data entry.

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