Service Representative Administrative Assistant
Resume:
KAREN CLAYTON
P.O. Box ****, Wilmington, DE ***** 302-***-**** Email: advw5b@r.postjobfree.com
RESUME PROFILE:
Highly motivated individual with proven track record for getting the job done. More than fifteen years’ experience in various lines of business, including administrative, healthcare, IT, fraud and insurance claims. Strong interpersonal skills; innovative problem solver; excellent listening, written and oral communication skills.
EXPERIENCE:
OptumRx - Remote November 2021 - Present
UnitedHealthcare
Customer Service Advocate
Inbound calls from members with benefit questions or
Home delivery refills on medications.
Goodwill Staffing Service May 2018 – December 2018
State of Delaware – Receptionist
Answer phones, taken detail messages
Distribute the mail and monthly census log for the state service centers
Aerotek Staffing October 2016 – May 2017
Fraud Analyst II – Call Center
Bank of America – Newark, DE
Inbound calls from customers regarding debit card. Process claims for fraudulent activity on an account and process payment through EPS system. Outbound calls made to the customer for authentication. Solved credit disputes. Network with other departments
Collabera Staffing July 2015 – October 2015
Fraud Analyst II – Call Center
Bank of America – Newark, DE
Inbound calls from customers regarding credit card. Process claims for fraudulent activity on an account and process payment through EPS system. Outbound calls made to the customer for authentication. Network with other departments
Outbound Customer Service Representative April 2015 – May 2015
CSS Staffing - Newark, DE
Outbound calls made to customers to upgrade their payment methods upgrade new payments in Zuroa
Administrative Specialist I January 2013 – February 2015
State of Delaware - DMMA, New Castle, DE
• Process incoming prior authorization request forms and medical authorizations.
• Answer calls and direct callers to proper agencies; file and maintain all department
documentation, forms and nurse’s visit list spreadsheets.
• Responsible for all unit administrative duties, coordinate meetings, reserve space and take
minutes at agency meetings.
Administrative Specialist June 2012 – November 2012
State of Delaware – DVI, New Castle, DE
• Created and maintained task files for para-transit tickets, rescheduled appointments and handled all
administrative duties.
• Scheduled all intake appointments for the Vocational Rehab Counselors.
• Made outbound calls to consumers for survey updates.
Administrative Assistant/Clerical October 2010 – June 2012
The Salvation Army/Family Services, Wilmington, DE
• Performed various clerical duties that supported both Family Services and the Homeless Shelter for
Women and Children.
• Maintained comprehensive case records, summaries, client logs, supply inventory, room availability
log and incoming phone calls.
• Assisted with the stocking and distribution of the food and clothing closets.
Fraud Detection Analyst II May 1997 – July 2007
First Data Corporation, Wilmington, DE
• Reviewed inbound Debit Card POS activities through fraud detection system and reported any
anomalies.
• Contacted cardholders on behalf of issuing institutions to alert them of irregularities in card activity.
• Followed established procedures for card blocking and updating potential fraud cases and status files.
• Performed other duties as assigned, including hot carding cards, card activation and ATM machines.
Additional Work Experience:
Over seven years’ experience as a Claims Examiner and Claims Analyst, processing medical claims, reviewing and processing hospital indemnity, Annuity and Medicare supplement claims.
AIG Insurance Company, Wilmington, DE
CIGNA Insurance Company, New Castle, DE
EDUCATION:
Work Courses:
Certificates: Customer Service, Claims Processing and Business Writing.
National Institute of Careers, Wilmington, DE
Graduated: Medical Assistant Program
Howard High School, Wilmington, DE
Graduated: Diploma-Commercial Foods
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