Resolution Specialist Resume Samples

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W Nitzsche

Werner

Nitzsche

6236 Raina Expressway

Philadelphia

+1 (555) 428 0292

6236 Raina Expressway

Philadelphia

Phone

p +1 (555) 428 0292

Experience Experience

Philadelphia, PA

Claims Resolution Specialist

Philadelphia, PA

Fadel-Shields

Philadelphia, PA

Claims Resolution Specialist

Assist the Supervisor with workforce management tasks and follow up
Provide the very best service to internal and external members and providers when having to take calls and receive calls
Answers questions and provides sound guidance to assigned client groups (predominately new hires) related to Inside Auto Physical Damage (APD) claim handling
Reports coverage denials to manager
Review and work incoming claims correspondence
Prioritizes and organizes own work to meet agreed upon deadlines
Work with supervisor to solve basic claims processing problems

Boston, MA

Customer Resolution Specialist

Boston, MA

Price-Wintheiser

Boston, MA

Customer Resolution Specialist

Searches customer comments within the Customer Listening Engine to open, update and close alerts, research customer comments and identify customers at risk of cancelling Cox services
Reviews customer inquiries, problems, requests and suggestions from cross-functional customer surveys (Retention, Field, Customer Care, and Retail) and single customer corporate escalations from the General Manager’s, Regional, or Corporate offices or other sources
Accesses ICOMS and a variety of other Company databases to conduct research on customer complaints regarding previous requests, actions taken and the root causes of problems
Coordinates with internal resources such as the Customer Advocate team, Comm Center, Retention, Field, Sales, Marketing, MTC Technicians, Risk Management, HDT Technicians, and Customer Care Center to resolve customer inquiries and move to resolution
Updates accounts with CPNI information, including web site notification for Customer Proprietary Information and note account for sales efforts
Determines and applies credit and adjustments as necessary, as necessary, by balancing customer satisfaction with corporate fiscal responsibility
Avoids disconnects and downgrades by emphasizing the benefits of Cox products and services

present

Phoenix, AZ

Customer Resolution Specialist / Arbitration

Phoenix, AZ

Rippin LLC

present

Phoenix, AZ

Customer Resolution Specialist / Arbitration

present

Review customer complaints and mechanic reports about vehicle condition
Inspect vehicle to determine extent of repairs, if any, and authorize second opinion, if necessary
Advise customers of Auction policy and the complaint and arbitration process and facilitate the resolution/negotiation between the two parties
Have awareness of and resolve after-sale problems, such as issues with title, mileage, frame damage, etc
Monitor and maintain accurate files for each arbitration case, and interact with Auction sales personnel regarding information on vehicle sales, etc
Act as a liaison with federal and state authorities regarding odometer rollbacks, salvage vehicles, etc
Promote the Auction and its services with customers to gain additional business including, but not limited to, post sale inspections

Education Education

Bachelor’s Degree in Complexity Necessitates

Oregon State University

Bachelor’s Degree in Complexity Necessitates

Skills Skills

Ability to handle multiple projects at the same time and ability to prioritize effectively
Strong decision making ability and problem solving skills
Detail oriented and strong organizational skills
Proficient in use of desktop applications
Strong interpersonal communication and follow-up skills
Excellent oral and written communication skills
Comfort with working in a fast-paced, constantly changing environment
Motivation and initiative to work independently and as a team player
Flexibility in working longer hours or change in schedule, when necessary
Experience: At least 4 years’ of Auto Finance experience, including collections and experience that demonstrates effective customer service skills

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15 Resolution Specialist resume templates

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Account Resolution Specialist Resume Examples & Samples

Two to three years of experience in collections and/or customer service activities
Ability to identify and resolve exceptions and to organize and interpret information
Bilingual Spanish/English speaking skills a plus

Customer Resolution Specialist / Arbitration Resume Examples & Samples

Review customer complaints and mechanic reports about vehicle condition
Inspect vehicle to determine extent of repairs, if any, and authorize second opinion, if necessary
Mediate dispute and negotiate repair and/or pricing of disputed vehicles in order to arrive at a mutually acceptable solution and in an effort to keep vehicles sold
Have awareness of and resolve after-sale problems, such as issues with title, mileage, frame damage, etc
Monitor and maintain accurate files for each arbitration case, and interact with Auction sales personnel regarding information on vehicle sales, etc
Act as a liaison with federal and state authorities regarding odometer rollbacks, salvage vehicles, etc
Promote the Auction and its services with customers to gain additional business including, but not limited to, post sale inspections
Review customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines; make/advise on financial decisions regarding arbitrations
Interface with all departments involved in the complaint including the fact finding and investigative phases
Screen and input all qualified vehicles for post-sale inspection
Inform buyers and sellers on the process, cost, and timing for completion of all PSI or buyer claims
Visibly demonstrate safety commitment by following all safety and health procedures and modeling the behaviors related to such. Actively participate in support of all safety activities aligned with Safety Excellence
Minimum of 3-5 years of automotive, mechanical or body shop experience with complaint recording and resolution preferred
ASE certification, estimating preferred
Strong verbal and written communication and organization skills required
Effective report writing and composition skills preferred
Working knowledge of federal and state laws regarding arbitration of vehicles
Regularly required to stand, walk, reach, talk and hear
Frequently required to stoop, kneel, crouch, squat, and climb
Ability to lift 1-20 pounds

Websphere Commerce Technical Resolution Specialist Resume Examples & Samples

Basic knowledge in database administration skills (IBM Database 2 (DB2) and/or Oracle)
Basic knowledge in Unix system adminstration skills
Basic knowledge in experience in Java Development, Java2 Enterprise Edition (J2EE) and J2EE servers
Basic knowledge in Networking and Transmission Control Protocol (TCP)/Internet Protocol (IP)
Basic knowledge in basic understanding of electronic commerce

WAH Seasonal Service Resolution Specialist Resume Examples & Samples

Answers incoming phone calls from customers; works with customers to resolve declined credit cards, unconfirmed reservations due to nonpayment, processes refund requests, researches/resolves reservation problems and communicates outcome, processes reservation cancellations in a timely manner. Assists customers with large, complex or special reservations
Provides support to park personnel, agencies, and agents with reservation problems as required
Contacts customers regarding emergency closures
Reports trends in customer problems relating to training issues to a Supervisor
Performs general Call Center agent duties and responsibilities when needed
Uses interpersonal skills to develop a team relationship with peers, agents and other staff and uses the teamwork philosophy to further the goals of the Customer Service Department, commit to continuous process improvement in order to keep our Customer Service standards and practices meeting the needs of the customer and the company
Handling multiple projects/contracts within deadlines
Performs other duties as assigned
Assist with fulfillment duties as needed, including bank/post office runs, printing and organizing confirmation letters, processing and sorting mail, managing supplies
Must have a valid driver’s license and a vehicle which will be used by incumbent for bank and post office runs
Will assist with front desk admin duties as needed
This is a work at home seasonal position, at end of determined season the employee will return to previous job duties

Customer Resolution Specialist Resume Examples & Samples

Applies developed subject matter knowledge to addresses and resolves common and complex issues within established guidelines
Recommends new approaches and alternatives
Provides leadership and training to team members
Bachelor’s degree and 4-6 years of related experience
OR equivalent combination of education and years of related experience
Knowledge of real estate industry including home sale and lender requirements
Knowledge of equipment leasing and financing
Experience in customer resolution management
LI-CB

Credit Bureau Dispute Resolution Specialist Resume Examples & Samples

Four or more years of experience in clerical and customer service activities
Superior knowledge of products, services, terminology, procedures and systems related to assigned area
Ability to independently identify and resolve complex problems

Claims Resolution Specialist Resume Examples & Samples

Ensure P&P’s are read and understood
Review and work incoming claims correspondence
Process claims according to specific procedures and standards, meeting all positions production, quality and standards
Provide the very best service to internal and external members and providers when having to take calls and receive calls
Manually enter claims
Review and complete CPS Call Tracks
Review claim quality errors with the Supervisor
Assist the Supervisor with workforce management tasks and follow up
Solves routine problems on own
Work with supervisor to solve basic claims processing problems
Prioritizes and organizes own work to meet agreed upon deadlines
Handle escalate claim assignments
Research and resolve high priority client claim projects
Demonstrated multitasking abilities

Denial Resolution Specialist Resume Examples & Samples

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
Experience working in a Production Environment
Good Attendance history in current/past positions
Clear understanding and working knowledge of payer denials and appeals process
Clear understanding of Healthcare claims processing
Ability to work independently as well as in a cross-functional team environment by collaborating with others and sharing tools, skills, and knowledge
Solid problem-solving and analysis skills that demonstrate resourcefulness and attention to detail
A minimum of one year medical office experience and/or collection experience is required
A comprehensive knowledge of insurance is desired, related experience and/or training

Account Resolution Specialist Resume Examples & Samples

Monday – Friday 8 am – 5 pm with a Thursday 12-9 pm late night every other week
1 Saturday/month
1 Holiday or Sunday/quarter
Paid Training Class
Excellent Incentive potential up to $1,000 per month!

Lead Account Resolution Specialist M-thu Resume Examples & Samples

Basic Knowledge of UB-92 and Explanation of Benefits (EOB) interpretation
Ability to understand contracts
Understanding HIPAA/ regulations
Ability to provide effective training, coaching and mentoring
Ability to work successfully in a fast paced environment with frequent interruptions
Internal Candidates: 1-2 years of experience, preferably within the same department. Must have a documented record of above average performance, knowledge, skills and ability

Lead Resolution Specialist Liability Resume Examples & Samples

Able to manage the full-life cycle of all assigned claims files
Analyzes coverage and determines defense obligations
Independently conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans
Creates reservation of rights and coverage denial letters
Negotiates settlements with clients, client attorneys, and Public Adjusters
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary
Prepares reserve and settlement authority requests for client and carrier approval
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage
Has a solid understanding of claims processing and the insurance brokerage business
Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry
Handles claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethical requirements
Provides guidance and/or supervision to lower level adjusters. Incumbents at this level should be able to work at full case load capacity
High school diploma
7 or more years related claims experience required
Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level
Appropriately licensed and/or certified in all states in which claims are being handled
Knowledge of accepted industry standards and practices
Computer experience with related claims and business software
Bachelor's Degree
10 or more years of prior experience adjusting claims in applicable specialty area preferred

Lead Resolution Specialist Resume Examples & Samples

Able to manage the full-life cycle of all assigned claims files
Analyzes coverage and determines defense obligations
Independently conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans
Creates reservation of rights and coverage denial letters
Negotiates settlements with clients, client attorneys, and Public Adjusters
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary
Prepares reserve and settlement authority requests for client and carrier approval
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage
Has a solid understanding of claims processing and the insurance brokerage business
Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry
Handles claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethical requirements
Provides guidance and/or supervision to lower level adjusters. Incumbents at this level should be able to work at full case load capacity
High school diploma
7 or more years related claims experience required
Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level
Appropriately licensed and/or certified in all states in which claims are being handled
Knowledge of accepted industry standards and practices
Computer experience with related claims and business software
Bachelor's Degree
10 or more years of prior experience adjusting claims in applicable specialty area preferred

Senior Resolution Specialist Resume Examples & Samples

Able to manage the full-life cycle of all assigned claims files
Analyzes coverage and determines defense obligations
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans
Creates reservation of rights and coverage denial letters
Negotiates settlements with clients, client attorneys, and Public Adjusters
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary
Prepares reserve and settlement authority requests for client and carrier approval
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage
Has a solid understanding of claims processing and the insurance brokerage business
Has a basic understanding of the terminology and case law associated with their specialized claims niche/industry
Handles claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethical requirements
Incumbents at this level should be able to work at full case load capacity
High school diploma
5 or more years related claims experience required
Prior experience working within the applicable specialty claims area or demonstrated ability to handle unique/challenging claims issues
Appropriately licensed and/or certified in all states in which claims are being handled
Knowledge of accepted industry standards and practices
Computer experience with related claims and business software
Bachelor's Degree
Two or more years of prior experience adjusting claims in applicable specialty area preferred

No Fault Customer Claims Resolution Specialist Resume Examples & Samples

Communicates with policyholders, agents, witnesses, and claimants in order to gather information regarding claims and refers tasks to auxiliary resources as necessary. Responds to various written and telephone inquiries including status reports
Reviews medical records and bills to verify claimed treatment is causally related to the accident and is reasonable and necessary given facts of the claim
Makes effective use of loss management techniques (IMEs, Nurse Review, and Bill Review). Negotiates settlements with attorneys, claimants, and medical providers. Arranges for expert inspections involving third party or potential fraud actions as needed
Identifies and recommends referral of potentially fraudulent claims to the Special Investigation Unit
Recognizes continuous improvement opportunities and develops
Strong written and oral communications skills required. Good interpersonal, analytical, decision making and negotiation skills required
The capabilities, skills and knowledge required is normally acquired through a Bachelor’s degree or equivalent experience and 6-12 months of directly related experience
Ability to obtain proper licensing as required

No Fault Customer Claims Resolution Specialist Resume Examples & Samples

Manages, processes and resolves claims assigned by Claims Team Manager. Evaluates liability and settles claims within prescribed authority
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims and refers tasks to auxiliary resources as necessary. Responds to various written and telephone inquiries including status reports
Ensures adequacy of reserves
Confirms or denies coverage and liability and advises policyholders and claimants as to proper course of action
Makes effective use of loss management techniques (Direct Dealing; ICP; V3 checks; open end release; first call settlements). Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed
Identifies and recommends referral of potentially fraudulent claims to the SIU
Bachelors degree preferred, continuing insurance education desired
Thorough knowledge of insurance coverages, contracts & claims handling guidelines
Experience with general liability and auto liability encompassing injury and property losses
Experience with litigated claims
Ability to analyze variables, such as medical records and legal documentation
Ability to communicate effectively with people from all backgrounds and uphold our high standard of customer service
Negotiation and settlement skills
Hard work, honesty, integrity and unwavering business ethics
Detail-oriented organizational skills in a multi-tasking environment
Success driven individual who has demonstrated success in a claims adjusting role

Senior Resolution Specialist Resume Examples & Samples

Work in partnership with leaders and associates to diagnose and resolve a variety of issues involving team dynamics in the workplace, ensuring that all employment laws and policies are adhered to and while maintaining firm culture
Conduct confidential investigations into complex and sensitive allegations of misconduct regarding employment law and firm policy violations in a thorough, diligent and unbiased manner to protect the interests of the firm and its associates
Lead the resolution of various associate relations issues to include determination of disciplinary actions
Provide coaching and counseling to leaders on the delivery of performance feedback and, at times, provide that feedback directly
Prepare documentation of associate situations in a legally appropriate manner
Work with associates to provide support and assistance during times of personal challenge
Develop and implement HR programs and activities designed to improve overall morale, job satisfaction, and safety of associates
The ability to speak and write in a clear, concise and impartial manner when

Temporary Claims Resolution Specialist Resume Examples & Samples

Requires frequent coverage research and analysis resulting in final coverage decision
Evaluates loss details for additional parties to be notified or involved in the claim, such as Total Loss, PIP/Med Pay, Subro, Rental, SIU, Legal. Split the file as needed
Ensures payments processed as needed, or releases payment once liability decided
In larger claims locations where significant hiring occurs, in addition to complex claims handling, role will also be responsible for the following
Delivers formal training to assigned client groups (predominately new hires). Formal training is typically delivered one-on-one
Confers with managers to identify training needs and to ensure training content and materials meet those needs
Answers questions and provides sound guidance to assigned client groups (predominately new hires) related to Inside Auto Physical Damage (APD) claim handling
General knowledge of contract language, including regulatory and policy differences, legal liability and general insurance policy coverage
Associates degree or equivalent training plus generally two or more year's auto non-injury claims handling experience
Customer Service experience preferred

Executive Resolution Specialist Resume Examples & Samples

Manages complaints according to bank-wide enterprise complaint process, ensuring all responses are within regulatory timeframes as well as internal Service Level Agreements (SLA), are handled in a professional manner utilizing discretion, and are accurate, clear, concise, and of the highest level of quality
Comprehensively researches issues, often in coordination with other departments and utilizing all applicable systems available, to identify root causes of the problems and determine appropriate resolutions
Analyzes customer needs on an ongoing basis to assist in identification of recommended enhancements to drive efficiencies and/or streamline processes, while supporting the corporate and bank objectives for customer care
Maintains a positive and customer-centric focus in dealings with customers and business partners alike
Utilizes a case tracking system to document all communications with complainants, including key dates of contact, in-depth information about the issues/complaints experienced, resolutions shared with customers, applicable regulations with each issue/complaint, relevant research, and associated supplemental attachments
Assists in preparing quantitative and qualitative reports, which track information and measure results for comparison to standard metrics
Reviews each inquiry and/or complaint for quality control and corrective action
Demonstrates behaviors which are aligned with the Ally LEAD culture
Performs other duties or responsibilities as required or assigned
Strong written, oral, and interpersonal communication skills with a proven ability to communicate and influence effectively at all levels of the organization
Excellent organizational and time management skills, with ability to prioritize workload to meet internal and external customer expectations under tight timelines/established SLA's
Ability to be self-directed and work under pressure on multiple tasks concurrently, meeting deadlines in a fast-paced work environment with frequent interruptions and changing priorities
Current and comprehensive knowledge of banking concepts (including the legislative and regulatory environments), and familiarity with financial planning and retirement services design
Solid knowledge of customer care practices and the ability to identify and understand risk. Exceptional customer service skills with the ability to actively listen, present a professional telephone demeanor, and resolve conflicts with potentially upset customers
Strong working knowledge and ability to quickly learn and use full capabilities of business systems to access customer information for research and resolution of customers' issues
Solid research skills including gathering and analyzing information or data from multiple sources and making actionable recommendations
Must be a team player with strong negotiation skills and the ability to resolve conflict and problems effectively Ability to develop and maintain strong internal & external business relationships
Strong decision-making and problem solving skills, using sound judgement and discretion, with the ability to resolve conflicts under pressure and to work independently without direct supervision
Flexibility and excellent interpersonal astuteness to respond to a wide variety of customer needs and personalities using tact, diplomacy, and the human relations skill necessary for dealing with a diverse audience
Detail oriented with intense follow-through abilities
Ability to analyze complex processes and procedures, identify root cause of process or customer pain points, and offer recommendations for improvement or other corrective action measures
Fundamentally strong in Microsoft Office Suite
Comprehensive knowledge of Ally Bank products, services and service standards preferred
Solid knowledge of competitors' products, services and marketing strategy

Resolution Specialist Resume Examples & Samples

Review accounts and gather background information pertaining to customer claims regarding issues with collateral
Communicate with customers via telephone to ascertain facts giving rise to underlying issues
Communicate with dealerships via telephone to ascertain facts giving rise to underlying issues
Research and investigate customer claims using effective skip tracing and investigative research techniques
Coordinate resolution efforts with GOLF Dealer Recourse, Sales, Titles, and other internal departments as applicable
Effect continued collections efforts on assigned accounts
Monitor accounts and follow up as necessary
Review accounts pertaining to issues that arise from dealerships going out of business and gather background information using effective skip tracing and investigative research techniques
Communicate via telephone, email, and written correspondence with customers, GOLF Titles & other internal departments, government motor vehicle & title agencies, and outside counsel to secure motor vehicle titles and resolve customer issues that arise from dealerships going out of business
Assemble documentation for outside legal counsel and follow up with legal counsel as necessary
Monitor and follow up with pertinent parties regarding out of business dealer accounts
Undertake other projects/duties as assigned by Manager
Demonstrate effective skip tracing techniques and collection strategies
Proficient in use of desktop applications
Excellent oral and written communication skills
Detail oriented and strong organizational skills
Strong decision making ability and problem solving skills
Strong interpersonal communication and follow-up skills
Ability to handle multiple projects at the same time and ability to prioritize effectively
Motivation and initiative to work independently and as a team player
Comfort with working in a fast-paced, constantly changing environment
Flexibility in working longer hours or change in schedule, when necessary
Education: High School diploma or equivalent. Bachelor Degree preferred
Experience: At least 4 years’ of Auto Finance experience, including collections and experience that demonstrates effective customer service skills

Case Manager & Problem Resolution Specialist Resume Examples & Samples

High school diploma with three to six months of relevant experience preferred
Courteous with strong customer service orientation
Strong computer navigation skills and PC knowledge
Dependable with strong attention to detail
Skilled in multi-tasking; including the ability to be flexible and adapt to changes quickly
Tolerance for repetitive work in a fast-paced, high production work environment
Demonstrate patience in all customer contact situations; including maintaining a pleasant and professional tone and manner
Ability to rotate shifts, as needed
Based on location and/or program, additional experience/skills may be required
Job requirements may vary by country and will not contravene any local laws

Senior Case Manager & Problem Resolution Specialist Resume Examples & Samples

Handle escalated complaint calls regarding repairs to vehicles priced between $20,000-$70,000
Research up to 60 percent of time to be prepared prior to interaction with customer
Keep customer service satisfaction scores high, listen, empathize, resolve
Identify gaps in Customer Service
Able to give up to an assigned amount in credit toward customer resolution when necessary to resolve customer complaint/inconvenience
Six month learning curve in being knowledgeable enough to feel comfortable in role

Customer Resolution Specialist Resume Examples & Samples

Searches customer comments within the Customer Listening Engine to open, update and close alerts, research customer comments and identify customers at risk of cancelling Cox services
Reviews customer inquiries, problems, requests and suggestions from cross-functional customer surveys (Retention, Field, Customer Care, and Retail) and single customer corporate escalations from the General Manager’s, Regional, or Corporate offices or other sources
Accesses ICOMS and a variety of other Company databases to conduct research on customer complaints regarding previous requests, actions taken and the root causes of problems
Contacts customers, asks questions and listens to understand their needs, requests or problems and to determine appropriate solutions and/or responses
Resolves customer problems by applying understanding of product features and network technology, billing, current sales campaigns and collection practices
Coordinates with internal resources such as the Customer Advocate team, Comm Center, Retention, Field, Sales, Marketing, MTC Technicians, Risk Management, HDT Technicians, and Customer Care Center to resolve customer inquiries and move to resolution
Coordinates trouble tickets, repair calls and phone calls, to resolve customer issues. Negotiates appointment times with customers, as appropriate, and tells customer if there is a charge for the service call
Updates accounts with CPNI information, including web site notification for Customer Proprietary Information and note account for sales efforts
Determines and applies credit and adjustments as necessary, as necessary, by balancing customer satisfaction with corporate fiscal responsibility
Uses understanding of how to move issues through the business to determine the best course of action for escalated issues and the right business partners to engage to bring resolution to customer issues
Avoids disconnects and downgrades by emphasizing the benefits of Cox products and services
Use established processes for dispositioning the customer contact, requests/issues and resolutions within CLE and ICOMS and other databases
Inspires customer loyalty by listening, empathizing, displaying ownership and providing timely communication until all issues are resolved
Answers inbound and makes outbound customer calls, emails, kana messages, etc. concerning troubleshooting or questions about Cox products and equipment. Ensures customer satisfaction using advanced customer service skills and in-depth knowledge of products, services and processes
Educates customers on products, customer owned equipment, use of browser, use of email, changing passwords and other member services features, as well as billing and Cox policies and procedures
Articulates the value of Cox products and services and current campaigns to resolve escalated problems and retain customers
Communicates and collaborates with internal and external customers to solve problems, confirm problem resolution and closes out problems
Provides feedback to boundary partners and front line leaders about how problems have been resolved. Uses standard escalation protocols, as appropriate, to provide feedback to business partners on transactional issues
Provides follow up and documentation of the resolution of problems to escalation originators and key stakeholders
Networks with supervisors to ensure accurate and prompt resolution is achieved and to avoid repetition of similar issues in the future
Participates in team or departmental meetings and individual meetings with Supervisor concerning own job performance
Attends job-related training; refresher training; product, service, and customer experience updates; and cross training
Reads new or updated reference material or announcements pertaining to construction schedules, outages, promotions, programming changes, specials, policies and other Company business. These may be provided by memo or electronic bulletin board, e.g., e-mail or the Knowledge Center. Adapts customer communication to reflect any changes

Resolution Specialist Resume Examples & Samples

Documents and updates the PACE (Patient Advocacy at Change Healthcare System) based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required
Reviews inbox for daily work queues, identifies missing evidence and follows through to completion
Answers incoming calls from clients and Health Care Representatives
Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process
Effectively educates and answers inquiries from patients and family representatives regarding application process
Assists clients with scheduling appointments and reminding of appointments, as needed
Maintains ongoing communication with other internal Resolve Application functions to obtain information and/or provide updates regarding claim status
Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process
Reviews software system for document mailings prior to applications, medical records, etc. is packaged and mailed to external sources
Receives calls and assists clients, company representatives and Healthcare Reps in resolving evidence application issues
Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval
Identifies appropriate escalation points and works with Escalation Team Leader to resolve issues
Reviews outgoing client material for accuracy prior to submittal
Complies with ethics, privacy and compliance policies and procedures

Claims Resolution Specialist Resume Examples & Samples

Manages claims handling and resolves the most complex claims including but not limited to coverage issues, multiple car accidents (4+), specialty vehicles, service issues, high profile claims and litigation. Evaluates liability, coverage and settles claims within prescribed procedures and authority
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims. Responds to various written and telephone inquiries including status reports
Reports coverage denials to manager
Negotiates coverage and liability decisions with insured, claimant, claimant carrier
Special assignments or projects as assigned
Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment, are required
Licensing as required

Senior Resolution Specialist Work Comp Resume Examples & Samples

Able to manage the full-life cycle of all assigned claims files
Analyzes coverage and determines defense obligations
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans
Creates reservation of rights and coverage denial letters
Negotiates settlements with clients, client attorneys, and Public Adjusters
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary
Prepares reserve and settlement authority requests for client and carrier approval
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage
Has a solid understanding of claims processing and the insurance brokerage business
Has a basic understanding of the terminology and case law associated with their specialized claims niche/industry
Handles claims consistent with clients’ and corporate policies, procedures and “best practices” and also in accordance with any statutory, regulatory and ethical requirements
Incumbents at this level should be able to work at full case load capacity
High school diploma
5 or more years related claims experience required
Prior experience working within the applicable specialty claims area or demonstrated ability to handle unique/challenging claims issues
Appropriately licensed and/or certified in all states in which claims are being handled
Knowledge of accepted industry standards and practices
Computer experience with related claims and business software
Bachelor's Degree
Two or more years of prior experience adjusting claims in applicable specialty area preferred

Member Resolution Specialist Resume Examples & Samples

Logs, tracks, resolves and responds to all assigned inquiries and complaints while meeting all regulatory, CMS, and WellCare Corporate guidelines in which special care is required to enhance WellCare relationships; while meeting and exceeding all performance standards
Thoroughly researches issues and takes appropriate action to resolve them within turnaround time requirements and quality standards
Identify root cause issues to ensure enterprise solutions and communicate findings as needed
Acts as a liaison between internal departments on data gathering and problem solving while investigating problems of an unusual nature in the area of responsibility. Presents proposed solutions in a clear and concise manner
Assists with special projects as assigned or directed
High School or GED is required
Associate's Degree in a related field is preferred
1+ year of experience in a call center or customer service environment is required
6 months of experience in a healthcare environment is required
Demonstrated written communication skills
Demonstrated interpersonal/verbal communication skills
Ability to follow direction

Loan Resolution Specialist Resume Examples & Samples

Negotiate and finalize specific terms of retention or liquidation workout solution with borrower
Analyze financial statements, loan documentation and other relevant data to determine best workout solution
Conduct gain/loss analysis on loans to project any potential future loss versus the acceptance of a short sale, deed in lieu, or cash for keys
Facilitate disposition efforts with borrowers, loan officers, attorneys, real estate agents, title companies and/or other third parties. Follow up as needed to ensure closure of approved deals
Educate and counsel borrower on workout options and the implication of each option
Obtain transaction approval by preparing deal package for management review. Present liquidation offers that may result in a loss to management that will result in the maximum return for the company/investor
Maintain current status of each deal in loan servicing system; provide updates to management as needed; and gather documents for investor reporting
Initiate contact with customers who have defaulted on their mortgages
Contact is made through phone calls
Identify and attempt to resolve reasons for delinquency
Review delinquent mortgages on a daily basis to ensure proper resolution
HS Diploma or Equivalent
Three years liquidation/loss mitigation experience
First and second mortgage lien experience
Problem-solving skills
Ability to make decisions independently within set policies and procedures
Ability to read and interpret documents such as policy manuals, safety rules, operating and maintenance instructions, and procedure manuals; ability to interpret real estate legal documents
Personal computer knowledge, including proficiency in Word, Excel and Outlook
Knowledge of mortgage industry practices, terminology and technology platforms

Accounts Payable Resolution Specialist Resume Examples & Samples

Research and resolve goods receipt discrepancies
Collaborate with branch personnel including Branch Managers and Distribution Center (DC) personnel to resolve reconciliation issues within system and/or vendor relationships
Daily Procure to Pay invoice processing for all vendor segments and all invoice types
Effectively managing and prioritizing workload efficiently and accurately while maintaining a positive customer service culture
Engage in and suggest continuous process improvement ideas to use best practices for processing, resolving issues and using analytics to management
Provide vendor , DC and branch analytical support for Accounts Payable Manager and Shared Services Director
Demonstrate initiative on improvements to processes and analytics
5+ plus years of progressive accounts payable transactional and resolution processing experience
Possesses strong interpersonal and communication skills both written and oral
Positively contribute to the accounts payable and Shared Services team environment
Analytical, with the ability to analyze and interpret large amounts of information
Demonstrate strong knowledge of use of technology; preferred experience with Lawson, SAP, Outlook, Microsoft Office

Customer Resolution Specialist Resume Examples & Samples

Answers incoming phone HVAC sales and service phone calls as well as incoming sales phone calls for other Home Improvement products while extending highest level of quality member service
For inbound HVAC service calls troubleshoots issues with the members over the phone and resolves product related issues. Schedule service appointments as needed
Receives all calls with the understanding that the incumbent is forming the member' s first impression of the company. Responds in an enthusiastic, courteous, friendly and caring manner while selling the appointment to maximize lead to appointment conversion
Minimizes calls in queue as well as up-sells Home Improvement products and the value of the appointment
Overcomes member objections and utilize marketing offers where appropriate to secure the appointment
Maintains knowledge of how Home Improvement interacts with other departments within the Sears organization to provide appropriate member service to all Sears customers
Professionally communicate with sales, service, and production to assist as needed
Diffuses and calms agitated customers by relating with them, as well as resolving their complaints and accurately directing their calls to appropriate departments for further assistance
Directs calls to appropriate personnel when answer is beyond authority given, as defined by department policies and procedures
Retrieves information from various sources and conveys information to customers, and enters information into the computerized database
Supports any customer centric duties depending on company needs
Trade or technical school certification or diploma
In-depth home improvement product knowledge
Mechanical aptitude or knowledge in the repair of consumer appliance products

Bwpo Credit Resolution Specialist Resume Examples & Samples

Achieve excellence in performance by working collaboratively with others on BWPO initiatives
Supports and demonstrates the values of the BWPO by conducting activities in an ethical manner with integrity, honesty, and confidentiality. Demonstrates a positive, open-minded, can-do attitude. Represents a team perspective and willingness and enthusiasm to collaborate with others. Follows through on commitments and achieves desired results. Exhibits sound judgment, obtains the facts, examines options, gains support, and achieves positive outcomes
Maintain high standards of professional conduct at all times
Enthusiastically promote a cooperative team environment to provide value to all departments and customers. Act as a leader in creating a positive atmosphere within the team. Listen and interact tactfully, diplomatically and effectively without alienating others
High School diploma or GED equivalent required
One to Three years’ experience in medical billing and AR systems required
Effective communication, organizational and problem solving skills
IDXBAR and/or Epic knowledge preferred
Excellent computer keyboard skills
Effective communication and interpersonal skills to successfully interact with internal and external customers
Effective organizational and problem solving skills
Ability to manage multiple tasks/projects simultaneously
Knowledge of medical insurance rules and regulations with regard to patient responsibilities preferred
Adapt positively to changes in the work setting with ease

Customer Resolution Specialist Resume Examples & Samples

Resolution of complex customer inquiries
Leverage knowledge of systems and multiple sources of data to determine root cause of problems
Provide support and communication to customer service representatives in effectively handling customer inquiries
Assist in coaching and mentoring customer service representatives
Meet call quality guidelines in addition to other key performance metrics and competencies
Handle customer escalations with diplomacy and tact
Provide phone follow up with customers regarding sales and service plans guidelines
Research and analyze requests for service
Work with field personnel to accurately and efficiently complete customer requests
Work on specialized projects and assignments as needed
Provide routine reports to management team
Perform a number of customer service representatives duties at times of overflow and peak call volumes
Assist in communicating changes in processes and procedures to representatives
Complete other daily, weekly and monthly duties as assigned
2-3 years of relevant work experience
Utility industry experience a plus
Familiarity with contact center quality assurance roles and responsibilities
Subject matter experts in various programs, systems or process beyond that of the required baseline knowledge of all Customer Care Representatives
Scope or responsibility specific to multiple locations desired
Troubleshooting skills and ability to interpret data from multiple sources to determine root cause of problems
Regularly use spreadsheets, database and word processing software, and periodically learn new programs
Strong interpersonal skills and team orientation
Ability to effectively present information one-on-one and in small group situations

OTI Issue Resolution Specialist Resume Examples & Samples

8+ years of IT experience, preferably in financial services industry
2 years implementation experience using Actimize
Must have worked on RCM and SAM modules
Strong Java and SQL background with enterprise level implementation experience
Hands-on experience working on integrations using web services/REST/Messaging
Strong data collection skills using modestly complex SQL and the ability to present and explain the data
Critically evaluate information and decompose into detailed description of issue
Working with Business directly
BA/BS in Computer Science or related field
Excellent written and verbal communication skills -- comfortable proactively communicating with others both within and outside of the immediate team to resolve issues and get questions answered
High attention to detail with excellent analytical and troubleshooting skills

Account Resolution Specialist Resume Examples & Samples

Analyzes and researches denials and follows-up with the appropriate payor and/or patient to resolve the denial. Provides missing or additional information if necessary, to expedite the resolution of the denied claim
Perform all appeals and denial recovery procedures needed to appropriately and accurately resolve denied claims
Stays current in all aspects of billing requirements for all assigned payers
Performs research to determine that current policies, applicable coding and insurance guidelines, regulations and laws are being followed
Contacts payers, employers, customers, attorneys, etc. in an effort to expedite the payment of accounts
Evaluates processes and procedures and makes practical suggestions/recommendations for improvement or compliance
One (1) year of experience in medical billing/insurance follow-up
Microsoft Office experience
Ability to apply strong analytical qualities

Banking Resolution Specialist Resume Examples & Samples

Provide incoming call coverage when needed to assist customers with various online retail deposit products such online savings accounts and certificate of deposits
Access multiple electronic systems and document steps taken to efficiently service the customer
Participate in projects to drive operational excellence
Completion of ongoing compliance and remedial training as scheduled
Meet established goals for all metrics, including call quality, productivity and profitability quotas, and customer acquisition by focusing on maximizing service to customers
Minimum 2 years of customer service experience
Proficient with Microsoft Suite (including Word, Excel, PowerPoint, and Outlook)
Bachelor's Degree in Finance, Accounting, or Business
2 years of experience in financial services/banking environment/regulations
2 years of experience in portfolio servicing, loan/lease accounts reconciliations, booking, charges adjustments, payment histories, A/R system, ACH (Sure pay) setup, Loan Terminations, etc
Strong problem solving and analytical/accounting skills
Ability to multi-task in a fast paced environment
High level of accuracy and attention to detail

Customer Resolution Specialist Resume Examples & Samples

Responds to customers via inbound/outbound calls or written correspondence to the day-to-day activities generated by claimant, shareholders, or other participants with relation to accounts in a wide arrangement of companies and businesses; and provides customers with exceptional customer service and a positive impression of self and organization through courteous, prompt, and responsive resolution of customer inquiries
Researches account and transaction information and record to resolve issues and discrepancies; provides documentation on customer activities and information on products and services. Uses multiple computer systems to locate, interpret, and communicate information to provide exceptional customer service
Provides up to date and accurate information by utilizing knowledge of internal systems to source, interpret and communicate information to customers
Escalates more complicated issues to appropriate Team Leader or ATL; identifies stakeholder, claimant trends or common issues and communicates to their Team Leader or ATL as appropriate
Promotes additional services/ communication channels to customers when necessary
Position may be responsible for taking inbound or outbound calls to shareholders or brokers to collect votes as it relates to proxy solicitation campaigns
Delivers first-class customer service
Other duties or tasks as assigned by management
High school diploma/GED required. College degree preferred; or six months to one year related experience and/or training; or equivalent combination of education and experience
Ability to speak and hear on a telephone system is a requirement and essential function
Experience in financial services software and MS Office preferred
Strong ability to use technology – dual monitors, navigate multiple screens
Strong reading comprehension
Confident, friendly phone skills
Read and comprehend scripting in a clear manner
Good math skills – perform simple calculations

Medicare Claims Resolution Specialist Resume Examples & Samples

Reviews admission documents and verifies that information in HMS is consistent with the information on the admission forms
Process the daily billing, assuring that all claims are billed within 24 hours of placement into the clearinghouse
Verifies, utilizing website and/or phone, that the insurance company is in receipt of the bill no later than 10 days after the billed date
Communicates with the billing and collection staff issues that are identified with insurance carriers
Performs any additional duties and projects as assigned by the CBO management team
One (1) or two (2) years of billing or related work experience. Healthcare biling experience preferred
Basic computer proficiency including Microsoft Word; Outlook (email), and Excel spreadsheet applications
Excellent interpersonal communication skills including: face-to-face, verbal, electronic, and telephonic
Individual must be accurate, organized, and have good time management skills in order to meet deadlines and succeed in this role. Commonly required to use judgment and resourcefulness in this role

Collections Resolution Specialist Resume Examples & Samples

Respond to complaints, concerns and inquiries in accordance with company and Federal regulations. Collection activity that facilitates the maintenance of acceptable delinquency percentages as provided by financial management
Maintain systematic and organized support documentation related to the handling of any owner account
Full-time schedule M-F between 8:30am-5:30pm
Ability to work one night shift per week and one Saturday per month
Organizational skills; communication skills, proficient in Word, Access and Excel
2+ years of related experiences
Timeshare experience; skip tracing experience
4+ years collections/customer service experience

Account Resolution Specialist Resume Examples & Samples

2 years of experience in customer service
College coursework
2 years of experience in a customer service call center environment (healthcare), -or-
2 years of experience in full-time collections (healthcare)
2 years of experience in automated, computerized account follow-up systems
2 years of experience in customer service (healthcare)

Lead Account Resolution Specialist Resume Examples & Samples

Basic knowledge of CPT and ICD-codes
Basic knowledge of FDCPA is helpful
Must be able to demonstrate a strong proficiency in MS Outlook, internet, word and excel applications
Exceptional Analytical, technical and problem solving skills
Ability to work with a team setting and be supportive of the team members
External Candidates: 1-2 years of prior experience as a lead, trainer, or supervisor in a medical/hospital/ insurance related field. Must be familiar with insurance follow-up, collections, customer service. Call center background is helpful

Credit Card Chargeback & Resolution Specialist Resume Examples & Samples

Analyzes, processes, and resolves credit card dispute cases by applying federal and state regulations, Navy Federal policies and procedures, and credit card vendor’s regulations, relating to the cardholder's and the merchant's dispute resolution rights. Receives initial member dispute inquiries; investigates account history using statements, on-line systems, and system-generated reports; interprets dispute claims and applies numerous foreign and domestic chargeback reason codes and compliance regulations; places items into dispute; notifies cardholders; calculates and adjusts finance charges on the credit card accounts; requests photocopies; initiates chargebacks through the Total System’s Credit Card System (TSYS), Visa Resolve Online (ROL), and MasterCard MasterCom systems; files pre-compliance/compliance violations cases; responds to and file pre-arbitration/arbitration cases with Visa U.S.A., Visa International, and MasterCard International). Records account actions and case developments. Researches monetary adjustments from merchants. Documents chronology for arbitration and compliance cases filed. Tracks cases and monitors progress to prevent or minimize financial loss to members and/or Navy Federal using automated systems (e.g., Total System’s Credit Card System (TSYS), Image Plus/On Demand reports, and other databases). Requests information and documentation from credit card vendors, merchants, merchant banks, and cardholders to clarify details or resolve dispute cases within mandated time frames. Contacts cardholders regarding non-receipt of fraud affidavits; upon receipt, tracks and processes fraud affidavits. Compiles documentation and constructs cases to be filed against merchant banks when there is a violation of operating regulations or no chargeback. Scans chargeback documentation; researches scanned documents or accesses credit card vendors’ image system for disputed illegible items. Processes chargebacks on confirmed fraud accounts to reverse fraudulent transactions back to merchant banks and credit card vendors. Closes accounts determined to have fraudulent activity or are being abused by the legitimate cardholders. Places fraudulent/closed accounts in regional combined Warning Bulletin and takes action: charges-off items within defined circumstances and authority; makes decisions and recommendations on dispute cases and waives interest within an authorized limit; keeps other cognizant areas informed of the status and actions taken on accounts; responds to requests from members, other financial institutions, and vendors for information regarding the status of pending cases; counsels and educates members on foreign and domestic transaction processing (e.g., BASE I, BASE II and INET authorizations; floor limits; settlement; exchange rates; dispute resolution, etc.); prepares correspondence to members and other financial institutions
Handles complex cases and responds to urgent inquiries regarding case decisions, policies, and procedures. Escalates most complex cases to Supervisor. Completes account investigations and responds to actions generated by other financial institutions such as good faith collections, pre-arbitration and pre-compliance cases, chargebacks, and representments. Posts unposted transactions to member accounts: researches account history, rebuilds transaction information for charges, posts valid charges to accounts, and takes action to chargeback transactions posted to invalid or closed accounts. Researches, actions, and resolves Branch Office cash advance rejects, teller errors, incoming chargebacks, and retrieval requests; retrieves copies of cash advance vouchers and works with other areas of the credit union to offset the general ledger and obtain transaction authorizations. Processes retrieval requests and chargebacks on deceased cardholder accounts received from the Decedent Accounts Settlement section. Analyzes on-line internal accounting reports to identify and resolve outstanding chargebacks, retrievals, and reject adjustments: researches account detail, determines corrective action, and resubmits corrections to balance the general ledger. Sends and receives funds electronically from other financial institutions, processors, etc. and performs offsetting account adjustments. Analyzes fraud cases to ensure they are processed and resolved in compliance with CUNA Mutual Insurance regulations
Prepares summaries for Federal Agencies, management, and credit card vendors for cases filed with credit card vendor’s Arbitration and Compliance Committees. Stays abreast of Navy Federal and vendor program/system enhancements and changes in credit card vendor’s rules and regulations via training, meetings, and publications. Incorporates new information into existing procedures. Remains alert and informed of threats to account security, counterfeit operations, and stolen cards. Coaches and mentors new section/branch employees and assists with training and development
Performs other duties as assigned or as appropriate
Familiarity with credit card operations and dispute regulations/policies
Knowledge of credit and lending principles

Technical Resolution Specialist Resume Examples & Samples

Meets the SLAs associated with a high volume of customer cases, determining which cases are appropriate for you to resolve, and quickly contacting the customer to begin the resolution process
When troubleshooting with customers, provide them with clear direction on how they can fix the issue on their own or escalating/reassigning the issue to the appropriate group for resolution
The ability to clearly document and articulate the root cause of issues and resolutions to customers both verbally and written within the context of a customer service case
Participate in detailed and at times difficult conversations with customers regarding technical issues where the customer’s orientation may or may not be technical
Follow a set weekday schedule, with the possibility of night and weekend work with little or no advance warning
Participate in a rotating 24 X 7 on-call shift

Account Resolution Specialist Resume Examples & Samples

File claims using all appropriate forms and attachments
Research account denials and file written appeals, when necessary
Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim
Research account information to determine the necessary attachments or supporting documentation to send with each claim
Ensure the integrity of each claim that is billed
Document in detail all efforts in CUBS system and any other computer system necessary
Verify patient information and benefits
Appeal accounts in writing
Draft letters to clients
Maintain awareness of and actively participate in the Corporate Compliance Program
Assist with other projects as assigned by management
Maintain good working relationships with state and Federal agencies
Resolve accounts in a timely manner
Maintain a neat and orderly work station

Account Resolution Specialist Resume Examples & Samples

Demonstrated excellent communication and interpersonal skills
Experience managing multiple tasks or priorities
Demonstrated typing proficiency

Customer Resolution Specialist Resume Examples & Samples

Proactively diagnose customer requests/inquiries; customize and present proposed solutions, as well as next steps to the customer
Find innovative solutions to more complex or difficult issues with appropriate escalation to higher level staff, lead, Business Partner or vendor as defined in the operational procedures and knowledge base
Efficiently resolve customer's primary issue and also anticipate/address common downstream issues
Determine if customer requests/inquiries require escalation to tier two (Shared Service Office functional team) or three (functional Centers of Expertise) as defined in the operational procedures and knowledge base. If escalated, ensure customer is transferred and inquiry is owned by individual in the appropriate tier
Document customer interaction in Contact or Call Center technology system
Update and maintain Shared Services Office (SSO) knowledge base for the functions in scope
Advise customers on how to use self-service tools
Open, close, and manage requests through use of the Service Now portal
Utilize call center telephony technology to manage and monitor volume of incoming calls
Experience in a customer facing inbound Contact or Call Center environment with 5+ years of relevant experience
Experience with various Contact or Call Center computer related technologies required
Previous experience in a higher education setting
Familiarity with administrative processes, procedures, and systems within a university setting
Procure-to-Pay or Human Resources functional experience preferred

Credit Balance Resolution Specialist Resume Examples & Samples

Strong analytical skills and ability to think creatively and outside the box
Critical thinking skills to manage day to day basic operations or the ability to seek assistance when needed
Work steadily, efficiently and show constant vigilance to the details of the work
Be able to perform routine mathematical functions

Customer Resolution Specialist Bilinguals Also Encouraged to Apply Resume Examples & Samples

Investigates and resolves complex customer/client problems/concerns in a timely manner
Facilitates resolution of high level, escalated or sensitive customer/consumer complaints
Conducts complaint resolutions by either verbal or written contact with the customer/consumer using a broad level of discretion
Investigates researches and validates complaint resolution with other business units
Distributes incoming receipts amongst team members for business area
Prior customer experience (1 year minimum)
Computer Proficiency - Intermediate PC skills and knowledge including hardware and software
Excellent communication skills (both written and oral)
Regular, predictable attendance is an essential function of this job

Customer Resolution Specialist Resume Examples & Samples

Access to continuing education via the Kelly Learning Center
Enter, review and investigate documented Non-Product complaints from patients, payers and health care providers. This will include call review and the documentation of findings and retraining needs for the Customer Financial Services team (60%)
Handle escalated patient, payer and health care provider calls for the Customer Financial Services team, providing resolution and escalating requests as needed. Review calls that preceded an escalation to document retraining needs for individual representatives or business partners. (30%)
Provide monthly trending reports to Customer Financial Services leadership team as well as the specialists during team meetings outlining complaint and escalation totals and findings. (10%)
Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. Please submit your resume to the recruiter associated to this role in order to be considered for this position (GEOR324@kellyservices.com)

Account Resolution Specialist Resume Examples & Samples

General collections responsibilities in a fast-paced environment, where multi-tasking is key to ongoing success
Follow the established 10 step calling guidelines to assess the borrower's ability to pay
Evaluate the customer's circumstances and educate the customer on next steps of action
Participate in call campaigns using an automated dialer system
Responsible for making decisions based on indicators given on the loan
Process payments over the phone and answer general questions regarding a mortgage account/loan
Negotiate payment arrangements
Utilize all available skip tracing tools to locate borrowers
Identify and suggest alternatives to borrowers who are unable to pay
2 plus years of customer support, in an inbound call-center environment
Current, working knowledge of the Microsoft Office suite, including: Word, Excel, Access and PowerPoint
1 plus years of experience in a lending or collections environment
Ability to accurately type an average of approximately 40 words per minute
Experience with Fiserv, LPS, or similar system preferred
Fluency in a foreign language a plus
Bachelor's Degree in Business, Management or related field is preferred
Available to work over-time as requested and required by business need and communicated by your manager

Mortgage Resolution Specialist Resume Examples & Samples

Assist with researching all direct client complaints
Research and resolve State, CFPB, Regulatory, borrower and Better Business Bureau complaints
Assist in resolving and responding to Advocacy Request and Live person complaints
Excellent analytical abilities
Responsible for researching all Subpoena and Request for Information inquiries
Assist in answering monthly Client complaint audit reports
Respond to customer and client complaints addressed to Senior Management
Ability to multitask on various items and tasks while meeting strict timelines and deadlines
Review all opened QWR tasks and tickets daily as it relates to consumer/client request
Conduct monthly risk assessment reports regarding complaints
Must be able to work with all levels of Management, State Regulatory agencies and Legal Council
Full understanding of Loan Servicing that would include Foreclosure, Cash, Loss Mitigation, Bankruptcy, and Escrow department guidelines
Full understanding of Loan Servicing that would include all agency and federal guidelines
1 year experience in project management skills
Considerable knowledge of mortgage lending/servicing industry, over a variety of departments, including the knowledge needed to research and complete open tickets and task
Must be flexible, organized and have the ability to manage and prioritize daily assignments to include conducting preliminary surveys necessary for research, looking up data and finding research material for the study and ensure accuracy of the information being researched
Analytical with the ability to detect problems in workflow
Ability to work collaboratively with peers, company managers, and customers in a team environment to attain common goals
Ability to multitask on various items while meeting strict timelines and deadlines
Ability to communicate effectively both in writing and orally, in person and by telephone, with all levels of the organization
Candidates should have the ability to handle standard office equipment (e.g. personal computer, calculator, copier, facsimile machine, scanner, microfilm reader, etc.)
Candidates should be able to use common office suite software (Microsoft Office Products

Claims Subrogation Resolution Specialist Resume Examples & Samples

Negotiates settlements with responsible parties, their carriers or legal counsel. Where a compromise settlement can't be reached, directs legal action versus potentially responsible parties or file arbitration on matters that fall within the compulsory aspect of inter-company arbitration. Manages legal counsel on litigated matters
Communicates with policyholders and agents on the status of pending subrogation matters, where required by statute, regulation or service standards
Preserves evidence and protects the chain of custody. Arranges for expert analysis, including cause and origin evaluation
Partners with claims representatives regarding subrogation identification and investigation as needed
Provides early consultation on arising claims with subrogation potential to field claims personnel or staff
Assists with departmental training and communication as needed
Adheres to all applicable statues and regulations
Reimburses insureds’ deductible where appropriate
Technical knowledge of multiple claim lines. Excellent organizational and time management skills
Solid understanding of applicable statutes, regulations and case law with a bearing on legal liability, collections and subrogation processing
The capabilities, skills and knowledge required is normally acquired through a Bachelor’s degree or equivalent experience and 1-3 years of directly related experience

Senior Customer Resolution Specialist Resume Examples & Samples

Reviews and confirms warranty coverage upon notice from a homeowner or carrier
Acts as a mentor to less experienced customer resolution colleagues
Plans and negotiates resolution to the most issues and assignments
Obtains approval for expenditures involving warranty resolutions
Locates and assigned available network contractors and non-network contractors
Produces correspondence and reports
Supports the organization's quality program(s)
Strong knowledge of repair practices/restoration
Detailed oriented
Customer service oriented with the ability to build and maintain relationships
Oral and written communication skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Effective time management skills
Ability to work independently or in a team environment
Ability to meet or exceed Performance Competencies

Claims Resolution Specialist Resume Examples & Samples

Foster and maintain provider relationship to facilitate current and future negotiations by
Performing claim research and analysis to provide support for desired savings
Generating agreement by communicating with provider by written and verbal communication throughout the negotiation process; and
Partnering with internal and external clients, including Account Managers, Customer Relations, Provider Services, and direct client contacts as applicable
Meet and maintain established departmental performance metrics. Manage high volume of claims in a queue; keep current with all claim actions and meet client deadlines for working and closing claims
Initiate provider telephone calls with respect to proposals, overcome objections and apply effective telephone negotiation skills to reach successful resolution on negotiated claims
Address counter-offers received and present proposal for resolution while adhering to client guidelines and department goals
Identify and seek opportunities to achieve savings with previously challenging/unsuccessful providers
Participate in projects and initiatives, as necessary
Ensure compliance with HIPAA protocol
Demonstrate Company Core Competencies and values held within
The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary
Minimum high school diploma or GED; prefer Bachelor’s degree (B.A.) in related field
Minimum 3 years of experience in the health care or medical insurance industry (clinical, provider billing, provider collections, insurance or managed care), or 1 year experience as a Claims Resolution Specialist
State licensure certification preferred
Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) desired
Knowledge of commonly used medical data resources
Knowledge of general office operations and/or experience with standard medical insurance claim forms
Knowledge of applicable laws and statutes (state, local or federal) for positions focusing on Workers’ Compensation or automobile medical (“auto”) bills
Communication (verbal, written and listening), teamwork, negotiation and organizational skills
Ability to use clinical and coding based knowledge to negotiate applicable claims
Ability to provide attention to detail to ensure accuracy including mathematical calculations
Ability to commit to providing a level of customer service within established standards
Ability to organize workload to meet deadlines and participate in department/team meetings
Ability to analyze data and arrive at a logical conclusion
Ability to identify issues and determine appropriate course of action for resolution
Ability to display professionalism by having a positive demeanor, proper telephone etiquette and using proper language and tone
Ability to elicit trust and credibility with all levels of the organization
Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software
Ability to work with accuracy in a fast-paced environment
Ability to adjust/alter workflow to meet deadlines
Ability to work independently and handle confidential information
Ability to process detailed verbal and written instructions
Ability to mentor less experienced team members
Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

Lead Account Resolution Specialist Resume Examples & Samples

The team lead will be responsible for reviewing, analyzing, monitoring, reporting and reconciling the health system’s bad debt inventory
This position will require a strong knowledge in revenue cycle AR management and a strong working relationship with all external collection agencies and any other applicable vendors related to bad debt workflow for the health system
Duties include but are not limited to the following: monitoring bad debt placement files, troubleshoot and escalate file errors and missing files that cause reconciling issues, oversee/monitor collection agencies productivity and reporting, prepare monthly collections and performance reports for management as well as any adhoc reporting
Candidate should be proficient in computer operations with an intermediate knowledge of Microsoft excel

Customer Resolution Specialist Resume Examples & Samples

Performs or requests adjustments and contractual write offs as applicable
Maintains a thorough understanding of hospital and professional billing procedures and payment practices of state, federal and all third party payers
Resolves HB and PB customer service inquires which could include
Government/non-government payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities
Medical terminology, CPT-4, ICD-9, HCPCS, modifier coding and how these items drive reimbursement
Principles and practices of customer service and telephone courtesy
Organizational, planning, analytical and problem solving skills
Attention to detail and follow-through
Demonstrated verbal and written communication skills
Microsoft Office applications (Word and Excel)
Epic Professional Billing preferred

Accounts Payable Query Resolution Specialist Resume Examples & Samples

Support the RPO and AP Operations Supervisor with the on boarding of our service delivery partner and provide ongoing training and support to the SDP after the transition of the EMEA Accounts Payable function
Collaborates daily with SDP team to ensure escalations and outstanding issues are addressed and managed effectively
Effectively undertakes AP and SSC objectives including month-end, quarter end & year end close
Develops a deep understanding of AP tools and policy while working with the SDP to act as the voice of the business so to ensure the overall process is user friendly
Manages reporting requests and schedules delivery to business partners in conjunction with the SDP
Develops strong relationships with the business to ensure important AP information is proactively shared and provided to the SDP
Understands and communicates documented business policies and procedures including identifying, recommending, and implementing process changes
Provide feedback to RPO and AP Operations Supervisor on suggested changes to current processes and policies in order to gain efficiencies and overall compliance with all programs
Delivers training on AP and policy to all levels of users in the organization as required
Working knowledge of information systems such as Concur, JD Edwards
Proficient in Excel and Powerpoint
Experience of the SSC environment
2nd European language
Degree/Diploma in accounting-related discipline
Permanent Full Time Position
Occasional overseas travel may be required
Additional hours at critical times (e.g, month end) may be required. Also, and on an exceptional basis, the role may require Public Holiday, and weekends

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