Jessica McElveen
Sumter,SC
Summary
Healthcare customer service professional with extensive experience supporting members and healthcare providers in high-volume call center environments. Skilled in claims support, eligibility and coverage verification, referral validation, and resolving complex account issues through phone and chat support. Recognized for strong communication, attention to detail, and maintaining excellent service while managing multiple systems and customer interactions.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Customer Service Representative
Blue Cross Blue Shield of South Carolina
Sumter, SC
02.2020 - Current
- Manage high-volume phone and chat interactions assisting members and healthcare providers with claims, benefits, and coverage inquiries.
- Research and resolve claim inquiries to support accurate and timely claims processing.
- Verify patient eligibility, coverage dates, benefits, referrals, and authorizations for medical services.
- Explain insurance policies, claim status, and benefit details clearly to members and providers.
- Maintain documentation of interactions while ensuring compliance with company policies and HIPAA regulations.
Customer Service Representative
Sykes Enterprises
Sumter, SC
06.2016 - 08.2019
- Assisted customers with account inquiries, billing questions, and service requests.
- Maintained accurate customer records while documenting interactions.
- Resolved issues efficiently while meeting call center performance goals.
Manager
Taco Bell
Sumter, SC
01.2007 - 01.2015
- Supervised employees while maintaining high customer service standards.
- Managed scheduling, inventory, cash handling, and daily operations.
- Trained staff on procedures, safety standards, and conflict resolution.
Customer Service Representative (Part-Time)
Conduent
Sumter, SC
01.2011 - 01.2013
- Provided customer support for account questions and service inquiries.
- Documented customer interactions and assisted with issue resolution.
Education
Central Carolina Technical College
High School Diploma - undefined
Lakewood High School
Skills
- Health Insurance & Claims Support
- Medical Terminology
- Provider & Member Assistance
- Eligibility & Coverage Verification
- Referral Verification
- Call Center & Chat Support
- Customer Issue Resolution
- Data Entry & Documentation
- CRM Systems
- Microsoft Office
Certification
- Medical Terminology
- Phlebotomy Technician
Timeline
Customer Service Representative
Blue Cross Blue Shield of South Carolina
02.2020 - Current
Customer Service Representative
Sykes Enterprises
06.2016 - 08.2019
Customer Service Representative (Part-Time)
Conduent
01.2011 - 01.2013
Manager
Taco Bell
01.2007 - 01.2015
High School Diploma - undefined
Lakewood High School
Central Carolina Technical College