Jessa Duran

Detail-oriented customer service professional with experience in healthcare customer service, claims support, eligibility and benefit verification, and high-volume case management within fast-paced environments. Knowledgeable in medical billing processes, insurance claims lifecycle, prior authorization requirements, and healthcare operations. Skilled in reviewing account information, resolving claims and billing-related inquiries, maintaining accurate documentation, and navigating multiple healthcare systems while ensuring HIPAA compliance and service quality.

Customer Service Representative / Coach at Optum Global Solutions – UnitedHealth Group (2022-11 – 2026-06)

• Assisted members and providers with inquiries related to claims status, benefits, eligibility verification, and authorization requirements.
• Developed a strong understanding of medical billing processes and healthcare insurance operations through daily interaction with claims-related concerns.
• Utilized multiple healthcare systems to review account information, validate member data, and document case activities accurately.
• Investigated and resolved billing and claims-related inquiries while ensuring timely and accurate case resolution.
• Maintained detailed and audit-ready documentation in compliance with HIPAA regulations and organizational policies.
• Managed high-volume cases while maintaining productivity, accuracy, and service quality standards.
• Coordinated with internal departments to escalate and resolve complex cases efficiently.
• Served as a Coach within the Training Team, mentoring new hires on workflows, system navigation, documentation standards, and compliance requirements.

Engineer Technical Support Representative at CSS Corp (2021-03 – 2022-10)

• Provided technical support for customer connectivity, applications, and system-related issues.
• Assisted customers with account access concerns and troubleshooting procedures.
• Documented customer interactions and resolutions within CRM and ticketing systems.

Sales Telemarketer at Venteny Inc. (2019-02 – 2020-06)

• Proactively reached out to prospective clients to promote products and services and generate sales opportunities.
• Utilized strong communication and relationship-building skills to engage customers and identify their needs.

NBN Technical Support Representative at TELSTRA Powered by TeleTech (2018-02 – 2019-01)

• Troubleshot connectivity and service concerns to ensure a seamless customer experience.
• Documented support interactions and maintained detailed account records.
• Demonstrated strong problem-solving and communication skills while handling high-volume customer cases.

Network Support Associate at Curo Teknika (2015-03 – 2017-11)

• Provided network and technical support for connectivity, hardware, and system-related concerns.
• Assisted end users with troubleshooting and issue resolution.

Bachelor of Science in Information Technology – ICCT Colleges Foundation Inc. (2011-08 – 2015-12)