Jamie Joe
Blue Cross and Blue Shield
Hartsville,SC
16
years of professional experience
Dynamic customer service professional with extensive experience at Blue Cross and Blue Shield, adept at conflict resolution and critical thinking. Proven track record of enhancing member satisfaction through effective complaint handling and accurate data entry, consistently achieving high-quality outcomes in fast-paced environments.
Work History
Customer Service Representative
2 Years 1 Month- Responded to member inquiries regarding benefits, eligibility, claims, and coverage information.
- Documented call details and resolutions accurately in customer service systems.
- Resolved routine account issues while maintaining compliance with HIPAA and privacy standards.
- Explained plan options, copayments, deductibles, and referral requirements in clear, concise language.
Customer Service Representative
4 Years 1 Month- Escalated complex claims and authorization issues to appropriate departments for timely follow-up.
- Navigated multiple systems to verify member information and process service requests efficiently.
- Maintained professionalism while handling high call volumes and diverse customer concerns.
- Collaborated with internal teams to support accurate case resolution and member satisfaction.
Customer Service Representative
4 Years 4 Months- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
Claims Adjuster
5 Years 1 Month- Investigated complex claims, reviewed policy coverage, and determined liability using established claims guidelines.
- Negotiated settlements with claimants, attorneys, and vendors while maintaining compliant documentation and file accuracy.
- Evaluated medical records, repair estimates, and loss reports to support timely claim resolution decisions.
- Directed claim handling strategies for high-exposure cases, ensuring adherence to regulatory and policy requirements.
- Analyzed claim trends and recurring issues to improve workflow consistency and file quality.
Education
High School Diploma
Skills
Customer service
Active listening
Critical thinking
Data entry
Customer relations
Call center experience
Computer proficiency
Conflict resolution
Complaint handling
Timeline
Customer Service Representative
Blue Cross and Blue Shield
10.2024 - CurrentRead More
Customer Service Representative
DXC Technology
08.2020 - 09.2024Read More
Customer Service Representative
Teleperformance
03.2016 - 07.2020Read More
Claims Adjuster
Skyes Enterprise
01.2011 - 02.2016Read More
Bishopville High School
High School Diploma
Read More