Jessica Rudison
Stockbridge,GA
Summary
Results-oriented Customer Service Representative with over 15 years of comprehensive experience across customer service, Sales, banking, insurance, healthcare, and finance sectors. Renowned for dedication to excellence, consistently delivering outstanding service and adeptly resolving intricate issues. Proven history of cultivating enduring client relationships, surpassing performance metrics, and catalyzing team achievements. Exceptional communication skills, coupled with proficiency in data entry, customer service relation advocate, technical and customer support. Committed to upholding the utmost standards of quality care while continually exceeding client expectations.
Overview
10
10
years of professional experience
Work History
MEDICAL APPEALS AND CLAIMS COORDINATOR
TalentBridge/Maximus Federal Services
05.2023 - 10.2023
- Orchestrated meticulous claim reviews, achieving accuracy rate of 98% prior to billing, mitigating risk of errors and delayed payments
- Leveraged in-depth knowledge of claims processing criteria and administrative guidelines to adjudicate or deny claims, contributing to 20% increase in process efficiency and consistency
- Demonstrated mastery of HIPAA regulations, medical terminology, and benefits claims processing, ensuring full compliance and minimizing legal exposures
- Streamlined inter-office communications, maintaining comprehensive case files, facilitating seamless transmission of critical data, and expediting claims resolution
- Implemented data management protocols for both hard copy and digital databases, leading to 25% improvement in data retrieval times.
CUSTOMER SERVICE PROFESSIONAL II
John Hancock Financial
Boston, MA
06.2021 - 04.2023
- Mastered the intricacies of 401k and pension plan transactions, including withdrawals, loans, and rollovers, to deliver personalized guidance on inbound calls, achieving a 'first-call resolution' rate of over 90%
- Maintained exemplary customer service standards, resolving complex inquiries, and delivering tailored financial advice, contributing to sustained customer loyalty and satisfaction
- Collaborated across the Institutional Investor Group Division to identify and implement workflow enhancements, resulting in a 15% increase in overall operational efficiency
- Consistently exceeded team quality goals and productivity expectations, reinforcing a culture of excellence and contributing to elevated service levels.
RADIOLOGY CENTRAL SCHEDULER
Carenet Health/UCLA Radiology
01.2019 - 03.2023
- Spearheaded high-volume appointment scheduling for multiple radiology modalities, achieving 99% on-time start rate and effectively handling 50-80 inbound calls daily
- Upheld rigorous HIPAA compliance while maintaining confidentiality in patient data handling, reinforcing organizational integrity and patient trust
- Elevated patient experience through professional and empathetic engagement, resulting in 95% satisfaction rate while streamlining operational procedures
- Orchestrated seamless interactions between scheduling, insurance, and clinical teams, ensuring prompt authorizations and reducing procedure delays.
HEALTHCARE REIMBURSEMENT, II
Talentbridge/CareMetx LLC
10.2018 - 03.2022
- Executed precise data entry for procedure and diagnosis codes into billing software, resulting in 98% accuracy rate, while simultaneously managing coinsurance deductible collections from patients
- Navigated complexities of insurance coverage, verifying patient-specific benefits across various payer plans and documenting specifics to enhance benefits verification efficiency
- Spearheaded efforts to resolve delinquent accounts and past-due invoices, successfully increasing revenue recovery rates by 20% and minimizing backlog of unpaid accounts
- Orchestrated effective appeal process for non-covered and low-pay claims, achieving 90% success rate in securing positive coverage determinations through external appeals
- Streamlined accounts payable by implementing robust verification checks, eliminating inaccuracies and ensuring timely electronic transfers and check generation.
CUSTOMER CARE SUPPORT REPRESENTATIVE II
US Bank Financial
05.2020 - 12.2021
- Handled inbound calls, effectively resolving both general and account-specific inquiries, which led to 95% customer satisfaction rate and achievement of key performance indicator
- Excelled in conflict mediation and problem-solving, de-escalating customer issues and providing tailored solutions, contributing to increase in customer retention and card membership growth
- Consistently exceeded performance goals across multiple dimensions, including customer survey results, sales rates, and compliance, bolstering overall team productivity and service levels
- Adhered to stringent financial services security protocols and audit procedures while maintaining confidentiality, reinforcing institutional integrity, and minimizing risk exposure.
HEALTHCARE PATIENT SERVICE REPRESENTATIVE/BENEFITS COORDINATOR
Talent Bridge/Ameri-Source Bergen
08.2018 - 10.2021
- Excelled in managing inbound/outbound calls, securing insurance verifications and authorizations, resulting in streamlined financial clearance for patient accounts and 98% first-call resolution rate
- Guided patients through complex paperwork, including history forms and payment contracts, while also expertly navigating patient inquiries to appropriate medical staff
- Maintained scrupulous attention to data integrity and confidentiality, ensuring full HIPAA compliance and seamless coordination of contracts and reimbursement outcomes
- Investigated and resolved patient authorization and claim issues, leading to reduction in patient-related complaints and corresponding increase in customer satisfaction ratings.
PHARMACY CALL CENTER REPRESENTATIVE II
BroadPath Healthcare
03.2018 - 12.2020
- Handled inbound pharmacy calls, efficiently addressing inquiries from members, providers, and pharmacies, resulting in exceeding departmental and CMS standards for service quality
- Orchestrated seamless coordination and processing of pharmacy prior authorization requests and appeals, contributing to15% reduction in delays and expediting patient access to medications
- Delivered exemplary customer service in billing inquiries and order statuses, leveraging in-depth knowledge of company products and services to improve sales and service quality metrics
- Expertly communicated complex plan benefit information, including formulary details, copay amounts, and pharmacy locations, achieving 95% customer comprehension rate
- Drove customer satisfaction ratings higher by capturing customer feedback, leading to implementation of targeted service initiatives and increase in overall customer satisfaction.
Customer Care Representative II
PNC BANK FINANCIAL
06.2017 - 01.2020
- Utilized strong interpersonal communication skills during client interactions, resulting in increased trust and fostering long-lasting relationships.
- Streamlined daily operations, ensuring accurate transaction processing and efficient customer service delivery.
- Presented new and additional products and services to existing customers.
- Handled various accounting transactions.
- Built strong relationships with customers by providing exceptional service and tailored banking advice.
- Managed risk effectively by conducting thorough credit assessments before approving loans or lines of credit.
- Improved client retention through effective communication and personalized banking solutions.
Technical Support Representative II
Apple Inc.
06.2016 - 03.2019
- Provided remote assistance to customers experiencing technical difficulties, guiding them through step-by-step resolutions with patience and professionalism.
- Continuously updated personal technical knowledge through participation in workshops, seminars, and self-study to better serve needs of clients.
- Tested new software and hardware prior to deployment.
- Worked closely with product development teams to report bugs and suggest enhancements based on customer feedback received during support interactions.
- Assisted in streamlining internal processes, reducing call wait times and increasing overall efficiency.
Product Support/Customer Service Specialist
Concentrix
02.2014 - 01.2018
- Exhibited high energy and professionalism when dealing with clients and staff.
- Maintained clean and orderly checkout areas by mopping floors, emptying trash cans and wiping down surfaces.
- Optimized customer support by establishing collaborative service environments through targeted operational initiatives.
- Tracked customer interactions using CRM software, helping team identify trends and areas of improvement in service delivery.
- Handled escalated calls calmly, finding resolutions that satisfied both company and customers needs.
- Responded proactively and positively to rapid change.
Account Management Specialist
Microsoft
01.2014 - 01.2018
- Selected correct products based on customer needs, product specifications and applicable regulations.
- Served customers with knowledgeable, friendly support at every stage of shopping and purchasing.
- Identified key entry points to enhance market penetration and maximize returns.
- Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
- Negotiated prices for products and freights to reduce cost of acquisition by achieving lower price.
- Liaised with marketing and sales teams to develop targeted campaigns.
Medical Record Documentation Specialist
Corizon Healthcare
01.2014 - 01.2016
- Conducted regular reviews of operations and identified areas for improvement.
- Gathered, organized and input information into digital database.
- Reduced costs by identifying inefficiencies in operations and implementing cost-saving measures.
- Attended training programs to deepen professional skillset and assisted in training fellow store associates on existing and new training programs.
- Managed budgets effectively, consistently staying within financial constraints while maximizing resource allocation for optimal results.
- Organized large-scale events, ensuring seamless execution of logistics, registration, catering, and venue management.
Education
Bachelor of Science - Accelerated Masters of Science Finance
Purdue University Global
West Lafayette, IN10.2024
Associate of Applied Science - Business Administration-Entrepreneurship
Purdue University Global
West Lafayette, IN09.2015
Skills
- Strong Verbal and Written Communication
- Strong Organization and Time Management
- Accurate Data Entry and Maintenance
- Leadership
- Adaptability
- Computer Literacy
- Microsoft Office Program Proficiency Skills
- Microsoft Word
- Complex Problem Solving
- Multitasking and Prioritization
- Conflict Resolution
- Report Preparation
- Remote Call Center Operations
- Excellent Organizational Skills
Timeline
MEDICAL APPEALS AND CLAIMS COORDINATOR
TalentBridge/Maximus Federal Services
05.2023 - 10.2023
CUSTOMER SERVICE PROFESSIONAL II
John Hancock Financial
06.2021 - 04.2023
CUSTOMER CARE SUPPORT REPRESENTATIVE II
US Bank Financial
05.2020 - 12.2021
RADIOLOGY CENTRAL SCHEDULER
Carenet Health/UCLA Radiology
01.2019 - 03.2023
HEALTHCARE REIMBURSEMENT, II
Talentbridge/CareMetx LLC
10.2018 - 03.2022
HEALTHCARE PATIENT SERVICE REPRESENTATIVE/BENEFITS COORDINATOR
Talent Bridge/Ameri-Source Bergen
08.2018 - 10.2021
PHARMACY CALL CENTER REPRESENTATIVE II
BroadPath Healthcare
03.2018 - 12.2020
Customer Care Representative II
PNC BANK FINANCIAL
06.2017 - 01.2020
Technical Support Representative II
Apple Inc.
06.2016 - 03.2019
Product Support/Customer Service Specialist
Concentrix
02.2014 - 01.2018
Account Management Specialist
Microsoft
01.2014 - 01.2018
Medical Record Documentation Specialist
Corizon Healthcare
01.2014 - 01.2016
Bachelor of Science - Accelerated Masters of Science Finance
Purdue University Global
Associate of Applied Science - Business Administration-Entrepreneurship
Purdue University Global
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