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Customer Service Rep

Location:
Decatur, GA
Posted:
May 01, 2015

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Resume:

Tamara T. Malone

517-***-****

*********@*****.***

Summary of Qualifications **License Adjuster

Professional with 4-6 years of progressive work experience in customer service,

claims, healthcare and web based troubleshooting. Proficient in processing orders

for customers and analyzing health/auto claims. Excellent customer service skills;

exceptional written and oral communication skills. Capable of building and

maintaining a team, time management, and problem resolution. Knowledgeable in

sales and upselling. Comfortable with leading and supervising. Well versed on MS

Office and the Internet.

Professional Experience

Claims Adjuster

Safe-Guard Products International Atlanta, GA July 2014-April 2015

• Mastered understanding of clients, agents, and contract terms and conditions.

• Corresponded with underwriters to address any concerns or questions related to

claims handling.

• Understand Exceptions based upon dealership, agent, or client as noted in system.

• Analyzed and process claims; approve and/or deny claim based on warranty

coverage and specifications for Tire & Wheel.

• Calculated and pay out benefits due.

Member Services Rep (Contract) January 2014-July 2014

Morneau Shepell Atlanta, Georgia

• Assisted with telephone inquiries pertaining to health insurance benefits;

PPO/HMO, premium billing and payment reconciliation in a high volume fast

paced inbound/outbound call center environment.

• Performed independent research as required to resolve errors and customer

concerns with logging in and setting up online accounts.

• Accurately documented call details, member information updates and actions

taken; ensure that all data entry is accurate and complete.

Claims Adjuster 2012-2014

State Farm Atlanta, Georgia

• Analyzed and managed property damage and casualty claims by investigating and

gathering information to determine the exposure of the claim.

• Assessed liability and resolve claims within evaluation.

• Calculated and pays benefits due, approves and make timely claim payments and

adjustments; and settles claims within designated authority level.

• Communicated claim activity and processing with the claimant and the client;

maintains professional client relationships.

Claims & Benefits Specialist 2010-2012

WIPRO United Healthcare Atlanta, Georgia

• Processed claim benefits for patients.

Verified insurance coverage for providers.

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Knowledgeable of billing and coding.

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Operated on healthcare software such as UNET, ISET, LifeWorks & SalesForce.

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Customer Service Rep

2010-2011

Convergent Inc. Atlanta, Georgia

Processed bill payments and resolve technical web support issues.

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Answered inbound calls in a high volume call center.

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Negotiated payment options and packages on behave of customer.

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Troubleshoot system errors for customers using the online app.

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Customer Service Rep 2009-2010

Donnelly Communications Inc. Atlanta, Georgia

Answered inbound calls in a high volume call center.

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Placed orders for customers utilizing mail catalogs and client web sites.

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Worked in 35 multiple queues and skill sets over various customer contact

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channels.

Troubleshoot online account errors for customers when purchasing online.

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Education

Michigan State University, East Lansing, Michigan May 2008

Bachelor of Arts, Telecommunications, Information Studies, and Media



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