Summary
Overview
Work History
Education
Skills
Timeline
Generic

JohnPaul Tow

Rio Rancho

Summary

Professional with robust experience in claims handling, prepared to excel in this role. Adept at analyzing and processing claims with precision, ensuring timely resolutions. Strong focus on team collaboration and achieving optimal results. Skilled in customer service, documentation, and regulatory compliance. Reliable and adaptable to changing needs.

Overview

22
22
years of professional experience

Work History

Claims Technician

Bluecross and Blueshield-HCSC
12.2024 - Current
  • Claims Technician receives, reviews, processes, and enters information for insurance or benefit claims

Sales Associate

Outline Menswear
09.2012 - Current
  • Assist with store opening and closing.
  • Assist with sale of clothing and apparel.
  • Cashier duties.
  • (As needed)

Claims Technician

Kelly Services – HCSC
10.2024 - 12.2024
  • Claims Technician receives, reviews, processes, and enters information for insurance or benefit claims

Stay-at-Home Father

Unemployed
04.2024 - 10.2024

Educational Assistant

Rio Rancho Public Schools – Rio Rancho Elementary School
01.2024 - 05.2024
  • In charge of the Workroom: Copies/Lamination/Spiral Book making/Poster Making/Supply Management/Die Machine (33.3% of day)
  • Educational Tech Assistant: Assist with on the spotcomputer/technology issues (33.3% of day)
  • Library Assistant: Check-in/Check-out books and materials/Caught damaged books/Assist with agenda and class preparation/Assist students with checking out appropriate level books
  • Other duties: Recess and Lunch duty/Creating bulletin boards for 3 area’s/MC’d for our Roadrunner Rally (Award Ceremony)/Substituted when needed

Customer Service Coordinator – Gamma Knife

LoveLace Hospital System – Radiation Oncology
10.2023 - 12.2023
  • Front Office duties
  • Patient Admission Intake paperwork
  • Eligibility/Referral verification
  • Payment Handling
  • Report Generating

Clerk III

New Mexico Early Childhood Education Care Department
05.2023 - 10.2023
  • Company Overview: (temp assignment through ATA Services)
  • Childcare eligibility/enrollment
  • Case update/change/filing
  • Reviewing submitted documentation for accuracy and collect additional needed documentation
  • Front Desk Customer Service

Customer Service Representative

Social Security Administration
11.2022 - 05.2023
  • Eligibility verification
  • Program enrollment
  • Case update/changes

Patient Services Specialist

Select Medical/BSW
10.2021 - 09.2022
  • Front Office duties
  • Patient Admission Intake paperwork
  • Eligibility/Referral verification
  • Payment Handling
  • Report Generating

Lead Axillary Support (temp position)

GISD
05.2021 - 10.2021

LegalZoom Inc.
01.2020 - 05.2021
  • Company Overview: (temp for Employment Professional)
  • Enrollment/Eligibility
  • Assist with Filing Business Entities.
  • Reviewing submitted application for Living Trust and Last Will and Testaments.

Alorica
07.2019 - 01.2020
  • Company Overview: (temp for General Motors Company)
  • Monitoring defense activities.
  • Managing and maintaining records regarding losses.

Sourcing Coordinator

RR Donnelly
09.2018 - 07.2019
  • Company Overview: (temp assignment through CornerStone Staffing)
  • Managing the company's supply portfolio ensuring transparency of spending.
  • Generating and implementing efficient sourcing and category management strategies.
  • Analyzing and calculating costs of procurement and suggest methods to decrease expenditure.

Claims Administrator

DIMONT
05.2015 - 12.2016
  • Company Overview: (temp assignment through CornerStone Staffing)
  • Administrating claims for professional and general liabilities.
  • Determining all expense reserves; coordinating with various departments to settle claims.
  • Monitoring defense activities.
  • Managing and maintaining records regarding losses.

Referral Coordinator

Concentra Urgent Care
09.2014 - 05.2015
  • Company Overview: (temp assignment through CornerStone Staffing)
  • Inbound/Outbound Call Center Obtain and updating patient appointment information.
  • Obtaining authorization to treat patient and refer out to specialist, physical therapy, and diagnostic testing.

Shift Supervisor

Starbucks Coffee
08.2013 - 09.2014
  • Investigated and resolved customer inquiries and complaints in an empathetic manner.
  • Cross-trained and backed up other customer service managers.
  • Met all customer call guidelines including service levels, handle time and productivity.
  • Assumed ownership over team productivity and managed work flow to meet or exceed quality service goals.
  • Strong leader of customer support staff.
  • Facilitated inter-departmental communication to effectively provide customer support.
  • Trained staff on operating procedures and company services.
  • Identified individual development needs with appropriate training.
  • Followed-through on all critical inter-departmental escalations to increase customer retention rates.

Membership Development Advisor

North Dallas GLBT Chamber of Commerce
06.2013 - 10.2013
  • Managed a portfolio of 120 accounts.
  • Handled 300 client companies and brought in 15 new accounts in one week.
  • Oversaw sales forecasting, goal setting and performance reporting for all accounts.
  • Created sales contacts with on- and off-premise accounts.
  • Organized joint sales calls with current customers and outside vendors.
  • Maintained a central database of key contacts, risk ratings, financial impact and key issues.
  • Built client relationships by acting as the liaison between the customer service and sales teams.
  • Created proposals for new and repeat customer business transactions.
  • Contacted regular and prospective customers to explain product features and solicit orders.
  • Consulted with clients after sales and contract signings to resolve problems and provide ongoing support.

Professional Development Specialist I

Brookhaven College
12.2012 - 06.2013
  • Enrollment/eligibility verification
  • Coordinated, scheduled and arranged meeting and travel calendars, including business and social events.
  • Obtained signatures for financial documents and internal and external invoices.
  • Maintained a clean reception area, including lounge and associated areas.
  • Greeted numerous visitors, including VIPs and vendors.
  • Opened and properly distributed incoming mail.
  • Answered and managed incoming and outgoing calls while recording accurate messages.
  • Directed guests and routed deliveries and courier services.
  • Managed office supplies, vendors, organization and upkeep.
  • Ordered and distributed office supplies while adhering to a fixed office budget.
  • Created detailed expense reports and requests for capital expenditures.
  • Planned and coordinated logistics and materials for board meetings, committee meetings and staff events.
  • Participated in training courses taught and lectured.

Student Services Specialist/Coordinator

Lone Star College
08.2009 - 10.2012
  • Fostered students' commitment to lifelong learning by connecting course materials to broader themes and current events.
  • Demonstrated a continued commitment to undergraduate teaching through full participation in the college community.
  • Guided students in using technology to support educational research.
  • Advised and mentored undergraduate students placed on academic probation.
  • Monitored students' academic progress and referred students who were struggling to campus resources.
  • Pointed students to relevant information about academic and personal support services available at the college.
  • Enrollment/eligibility verification

Personal Banker

Wells Fargo Bank
03.2008 - 08.2009
  • Assessed clients' financial situations to develop strategic financial planning solutions.
  • Collaborated with the compliance department to eliminate procedural errors and margin breaks. Reconciled debit reports, margin reports and trade settlement reports to reach in-house goals and objectives.
  • Enhanced the operational risk application to capture regulatory findings from agencies such as SEC and OCC.
  • Researched industry competitors and compiled detailed analysis data.
  • Enrollment/eligibility verification

Teller II

Sterling Bank
04.2007 - 03.2008
  • Scheduled staffing for the main branch.
  • Executed customer transactions, including deposits, withdrawals, money orders and checks.
  • Rapidly and efficiently prepared customer and ATM cash and change orders.
  • Organized, stocked and maintained the teller window area.
  • Processed quarterly Vault and A TM audits with a zero error rate.
  • Coordinated daily cash reconciliation at a high-volume location.
  • Handled various accounting transactions.
  • Collected member loan payments.
  • Sold cashier's checks, traveler's checks and money orders.
  • Executed wire transfers, stop payments and account transfers.
  • Advised clients on mortgage, educational and personal loans.
  • Maintained friendly and professional customer interactions.
  • Enrollment/eligibility verification

Customer Service Manager

Cingular Wireless
12.2003 - 04.2007
  • Investigated and resolved customer inquiries and complaints in an empathetic manner.
  • Cross-trained and backed up other customer service managers.
  • Adhered to all confidentiality requirements at all times.
  • Met all customer call guidelines including service levels, handle time and productivity.
  • Solved unresolved customer issues.
  • Promptly responded to inquiries and requests from prospective customers.
  • Assumed ownership over team productivity and managed work flow to meet or exceed quality service goals.
  • Strong leader of customer support staff.
  • Facilitated inter-departmental communication to effectively provide customer support.
  • Scheduled staff shifts to cover peaks and lulls in customer inquiries.
  • Provided accurate, specific and timely performance feedback for CSRs.
  • Identified individual development needs with appropriate training.
  • Maintained up-to-date knowledge of product and service changes.
  • Developed highly empathetic client relationships and earned a reputation for exceeding service standard goals.

Education

Associate of Arts -

Lone Star College
Houston, TX

Skills

  • Claims analysis
  • Claims processing
  • Microsoft office
  • Liability determination
  • Policy interpretation
  • Teamwork and collaboration
  • Attention to detail
  • Problem-solving abilities
  • Claims investigation and research
  • Procedure implementation

Timeline

Claims Technician

Bluecross and Blueshield-HCSC
12.2024 - Current

Claims Technician

Kelly Services – HCSC
10.2024 - 12.2024

Stay-at-Home Father

Unemployed
04.2024 - 10.2024

Educational Assistant

Rio Rancho Public Schools – Rio Rancho Elementary School
01.2024 - 05.2024

Customer Service Coordinator – Gamma Knife

LoveLace Hospital System – Radiation Oncology
10.2023 - 12.2023

Clerk III

New Mexico Early Childhood Education Care Department
05.2023 - 10.2023

Customer Service Representative

Social Security Administration
11.2022 - 05.2023

Patient Services Specialist

Select Medical/BSW
10.2021 - 09.2022

Lead Axillary Support (temp position)

GISD
05.2021 - 10.2021

LegalZoom Inc.
01.2020 - 05.2021

Alorica
07.2019 - 01.2020

Sourcing Coordinator

RR Donnelly
09.2018 - 07.2019

Claims Administrator

DIMONT
05.2015 - 12.2016

Referral Coordinator

Concentra Urgent Care
09.2014 - 05.2015

Shift Supervisor

Starbucks Coffee
08.2013 - 09.2014

Membership Development Advisor

North Dallas GLBT Chamber of Commerce
06.2013 - 10.2013

Professional Development Specialist I

Brookhaven College
12.2012 - 06.2013

Sales Associate

Outline Menswear
09.2012 - Current

Student Services Specialist/Coordinator

Lone Star College
08.2009 - 10.2012

Personal Banker

Wells Fargo Bank
03.2008 - 08.2009

Teller II

Sterling Bank
04.2007 - 03.2008

Customer Service Manager

Cingular Wireless
12.2003 - 04.2007

Associate of Arts -

Lone Star College

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