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Blue Cross Blue Shield of IL - Customer Advocate Specialist Resume Example

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Jackson Thompson
XXX XXXXXXXX XX , Catlin , IL 61817
Home: XXXXXXXXXXXX - XXXXXXXXXXXXXXXXXXXXXX
Professional Summary

I am a friendly and enthusiastic Customer Advocate Specialist with fifteen years of experience at Blue Cross Blue Shield of IL in several positions. I am able to learn new tasks quickly. I have excellent analytical and research skills required for this position.

Skills
  • Customer and Personal Service
  • More than 4 years of claims adjudication or claims administration experience
  • Experience completing projects in a timely manner
  • Knowledge of health care products and networks.
  • Analytical skills, research techniques
  • Clear and concise verbal and written communication skills
  • PC proficiency to include Blue Chip, Word, Excel, PowerPoint and Lotus Notes
Experience
03/2013 to Present
Customer Advocate Specialist Blue Cross Blue Shield of IL - Danville, IL
  • Resolve customer complaints or answer customers' questions regarding policies and procedures.
  • Supervise the work of customer service employees to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems.
  • Provide employees with guidance in handling difficult or complex problems or in resolving escalated complaints or disputes.
  • Train or instruct employees in job duties or company policies or arrange for training to be provided.
  • Discuss job performance problems with employees to identify causes and issues and to work on resolving problems.
03/2005 to 03/2013
Customer Advocate Blue Cross Blue Shield of IL - Danville, IL
  • Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
  • Review insurance policy terms to determine whether a particular procedure is covered by insurance.
  • Check to ensure that appropriate changes were made to resolve customers' problems.
  • Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
  • Refer unresolved customer grievances to designated departments for further investigation.
02/2000 to 03/2005
Membership Biller Blue Cross Blue Shield of IL - Danville, IL
  • Process and record new insurance policies.
  • Correspond with Employers to obtain information or inform them account status or changes.
  • Organize and work with detailed office records, maintaining files for each policyholder, including policies that are to be reinstated or canceled.
  • Review and verify data, such as age, name, address, and dependents to be added to the policy.
  • Transcribe data to worksheets and enter data into computer for use in preparing documents and adjusting accounts.
  • Examine forms from Employers, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
  • Compare information from application to criteria for policy reinstatement and approve reinstatement when criteria are met.
06/1999 to 02/2000
Insurance Claims Clerks Blue Cross Blue Shield of IL - Danville, IL
  • Transmit claims for payment or further investigation.
  • Pay or process claims.
  • Contact insured or other involved persons to obtain missing information.
Education
05/1992
Associate of Science: Computer Science
Danville Area Community College - Danville, IL
05/1989
High School Diploma: College prep courses/General Study
Danville High School - Danville, IL
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Resume Details

This is a real resume for a Customer Advocate Specialist in Catlin, Illinois with experience working for such companies as Blue Cross Blue Shield Of Il. This is one of the hundreds of Customer Advocate Specialist resumes available on our site for free. Use these resumes as templates to get help creating the best Customer Advocate Specialist resume.

Previous Companies:

  • Blue Cross Blue Shield of IL

Previous Job Positions:

  • Customer Advocate Specialist
  • Customer Advocate
  • Membership Biller
  • Insurance Claims Clerks

Schools:

  • Danville Area Community College
  • Danville High School

Level of Education:

  • Associate of Science
  • High School Diploma

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