[First Name] [Last Name]
Contact Address: [street]
[Country] [City] [State/Province] [Zip Code]
Contact Number: (012)-345-6789
Email Address: [[email protected]]
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Career Objective:
To work as a grievance coordinator with “Star Insurance Company” where I can investigate and resolve complaints of customers utilizing research skills and regulatory knowledge.
Summary of Skills:
- Experience in investigating and resolving complaints related to insurance
- Excellent communication, negotiation and convincing skills
- Skilled at studying data and identifying mistakes and loopholes within
- Superior research and investigative skills that help perform root cause analysis
- Excellent analytical, computer, and problem-solving skills
- A thorough professional with high regards to corporate ethics and mannerisms
Work Experience:
Grievance Coordinator
Fair Medical Billing, Inc., Peoria, AZ
April 2014 – Present
- Review and find solutions for customers’ complaints
- Collected medical history of insurers and consult medical expert on panel for clarification
- Gather facts, analyze the root cause of complaints, and draft report on findings
- Maintain files of all insurance policy holders and verify if the policy is still current
- Coordinate between grievance and appeals committee and settle matter outside the court
- Negotiate with customers and health-care providers and try to solve problems amicably
Grievance Coordinator
Fine Insurance Company, Peoria, AZ
August 2012 – March 2014
- Called meetings of policy holders and health care providers and attended their grievances
- Processed and resolved filed compliance according to the rules set by the company
- Saved millions of dollars for the company by researching and exposing false medical claims
- Prepared case files on policy holders and submitted for management review
- Sent acknowledgement letters to customers against complaint received and scheduled meetings nor negotiations
- Handled inbound calls and resolved complaints over the phone itself for minor problems
Education:
-
Bachelor’s Degree in Health Care
ABC College, Peoria, AZ
2011
Reference:
On request.