Seven Anderson
Columbus,OH
Summary
Dynamic problem-solver with a proven ability to identify challenges and deliver effective solutions swiftly and efficiently. Expertise in educating and informing customers through various communication channels demonstrates strong adaptability and interpersonal skills. Proficient in explaining documentation requirements, outlining timelines, providing payment details, and delivering claim status updates, ensuring customers feel supported and informed throughout the process. A track record of accuracy and precision in entering verbal and written information into claims management systems underscores meticulous attention to detail and a commitment to maintaining data integrity. Open to relocation.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Customer Service Assistant
TRC Talent Solutions- Job and Family Services
02.2025 - 08.2025
- Greets applicants, recipients, and visitors and provide necessary linkage with appropriate center staff.
- Accepts required verification from customers and routes to the assigned case manager.
- Provides support to caseworkers, responds to general inquiries.
- Conducts initial screening and registration of new applications and secures case files from the files area for use by the assigned case manager.
- Answers routine questions in reference to case status, benefits issuance, etc.
- Mail out customer’s request for income verification, childcare, public assistance, and PRC applications.
- Provide information to appropriate staff in response to inquiries received.
- Utilized problem-solving skills to address customer queries and complaints.
Claims Representative
Automated Health Systems
01.2024 - 02.2025
- Provide prompt and professional responses to inbound calls while conducting interviews with claimants applying for unemployment insurance benefits.
- Accurately collect and record essential information, including demographic details, wage history, work experience, severance and pension payments, and disputed eligibility statuses.
- Review accounts with over payments and address inquiries related to billing, collections, and repayment to ensure clear and efficient resolutions.
- Utilize active listening skills to identify customer needs effectively and enter claimant information with precision into the Beacon cloud-based system.
- Managed approximately 30 incoming calls, emails and faxes per day from customers.'
- Investigate and resolve issues related to individual unemployment insurance claims, demonstrating a commitment to delivering exceptional service and ensuring claimant satisfaction.
- Worked productively in a fast-moving work environment to process large volumes of claims
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Managed approximately 80-100 incoming calls, emails and faxes per day from customers.'
HR Specialist
Amazon
10.2022 - 01.2024
- Managed moderately complex claims, including pending, active, and appeal reviews, by conducting timely and accurate evaluations in compliance with state and insurance regulations.
- Managed benefits administration for company-wide staff, ensuring timely processing and accurate recordkeeping.
- Administered employee leave requests in accordance with FMLA guidelines, maintaining compliance with regulations while providing necessary accommodations for staff members.
- Ensured compliance with federal, state, and local labor laws through regular audits and policy updates.
- Resolved claim inconsistencies, worked with Fraud, Waste, and Abuse teams, and accurately calculated monthly benefits, including Social Security offsets, and processing Return to Work.
- Monitored employee attendance and performance, addressing issues in accordance with company policies and procedures.
Disability Claims Specialist
Jacobson Insurance staffing Group-( Prudential)
02.2021 - 09.2022
- Acted as the primary point of contact for clients, overseeing leave of absence administration (FMLA, STD, LTD) as outlined in client contracts, while managing a caseload of 100 to 275 cases.
- Communicated with claimants regarding required documentation, processing timelines, and claim status updates to ensure clarity and compliance.
- Processed disability and FMLA paperwork accurately and efficiently.
- Played a critical role in resolving customer complaints by addressing concerns and providing clear explanations about claim decisions, maintaining positive relationships with clients.
- Reduced claim processing time by conducting thorough assessments and providing accurate documentation for each case.
- Conducted comprehensive evaluations to determine eligibility for benefits, ensuring compliance with company policies and government regulations.
Leave of Absence Case Manager
York Risk Services Group
12.2017 - 12.2019
- Collaborated with client Human Resources departments to coordinate various types of leave.
- Inform claimants of documentation required to process claims, required time frames and claim status information.
- Determined eligibility and certification in compliance with state and federal guidelines.
- Monitored and tracked FMLA absences according to client-specific calendars, conducted analyses on compensation, benefits, and absence tracking to support informed decision-making.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
Service Center Representative
Sedgwick Claims Management Services
03.2015 - 11.2017
- Served as the primary liaison for callers, adhering to client specifications to address inquiries and resolve issues related to claims applications and servicing processes.
- Assigned new claims to the appropriate claims handlers to ensure efficient case management.
- Directed customer calls to the appropriate contacts across multiple locations or escalated complex issues to Service Center Specialists or management when necessary.
- Accurately entered verbal and written application information into the claims management system, meeting the needs of both internal and external clients.
- Educated claimants and callers on client requirements and benefit plans, documenting all call details concisely and professionally.
- Enhanced customer satisfaction by providing timely and accurate information on services.
- Maintained detailed records of customer interactions, ensuring accurate documentation for future reference or follow-up actions.
Collection Customer Service Representative
Iqor
09.2010 - 01.2015
- Exceptional customer service by communicating with customers via telephone and assisting with any questions regarding billing, explaining rates and allowance.
- Processing orders for installation , turn-on, discontinuance or change in service.
- Prepare documentation for contracts, transactions, or regulatory compliance.
- Reduced outstanding receivables by consistently following up on overdue payments and negotiating payment arrangements.
- Improved customer satisfaction by promptly addressing and resolving collection inquiries and concerns.
- Maintained updated customer account information, providing accurate billing statements and addressing inquiries promptly.
Education
Diploma - Medical Billing and Coding
Fortis College
Columbus, OH09.2020
Associate of Arts - Business Administration And Management
Colorado Technical University
Colorado Springs, CO03-2017
Skills
- Benefits management
- Accurate data entry
- Strategic decision-making
- Experience in case management
- Skilled in documentation management
- Effective problem resolution
- Customer service experience
- Skilled in software usage
Certification
- CPR Certification
- First Aid Certification
Timeline
Customer Service Assistant
TRC Talent Solutions- Job and Family Services
02.2025 - 08.2025
Claims Representative
Automated Health Systems
01.2024 - 02.2025
HR Specialist
Amazon
10.2022 - 01.2024
Disability Claims Specialist
Jacobson Insurance staffing Group-( Prudential)
02.2021 - 09.2022
Leave of Absence Case Manager
York Risk Services Group
12.2017 - 12.2019
Service Center Representative
Sedgwick Claims Management Services
03.2015 - 11.2017
Collection Customer Service Representative
Iqor
09.2010 - 01.2015
Diploma - Medical Billing and Coding
Fortis College
Associate of Arts - Business Administration And Management
Colorado Technical University
Similar Profiles
Latoya MartinLatoya Martin
Customer Service Representative at TRC/ Job and Family ServicesCustomer Service Representative at TRC/ Job and Family Services
Anthony BookerAnthony Booker
Social Services Worker II at Butler County Department of Job & Family Services - Adult Protective ServicesSocial Services Worker II at Butler County Department of Job & Family Services - Adult Protective Services
Elizabeth BerndtElizabeth Berndt
Case Manger at Geauga County Job and Family ServicesCase Manger at Geauga County Job and Family Services
Charrelle JacksonCharrelle Jackson
Machine Operator at Dupon USAMachine Operator at Dupon USA
Thomas WaglerThomas Wagler
Senior Quality Engineer at Abbott - NutritionSenior Quality Engineer at Abbott - Nutrition