Customer Service Claims Representative

Tiana Lowe

********@*****.*** 336-***-**** Mebane, NC

SUMMARY

Seasoned Claims Representative with 7 years of experience in the insurance industry. Expertise in policy coverage determination, claim resolution, and settlement negotiation. Seeking to leverage proven customer service skills and thorough understanding of claim processing as a Senior Claims Representative. WORK EXPERIENCE

Favorite Healthcare Staffing

Claims Specialist Feb 2020 - Oct 2023

• Managed the prompt and effective resolution of assigned cases by determining correct policy coverages and implementing appropriate claims practices.

• Scrutinized and ensured the accuracy of claims documents, escalating all cases to relevant departments as required for effective case resolution.

• Acted as a liaison for severe incident reports and reinsurance reports, fostering durable client relationships through prioritizing excellent customer service.

Conduent Services

Claims Processor Nov 2016 - Dec 2019

• Managed the comprehensive claim reporting process, ensuring accurate collection of adjuster information and claim numbers.

• Maintained precise records of claim recoveries, facilitating efficient tracking and acknowledgment of claims within the company system.

• Delivered resolution to claims through careful evaluation of documentation, computation of due benefits, and determination of compensation settlements, including successful negotiations with injured parties and legal representatives.

Lenovo

Insurance Claims Representative Jan 2015 - Dec 2017

• Provided high-quality customer service to assigned insured parties and claimants throughout the claims lifecycle, enhancing service times.

• Successfully negotiated settlements for straightforward claims in line with the actual company liability, ensuring fair compensation.

• Evaluated each claim for liability, compensability, and due benefits; accurately computed interest accrued, premiums due, and settlement surrender on loan values. EDUCATION

Essex County College

Associate Degree

SKILLS

Documentation Review • Coverage Assessments • Accident Investigations • Settlement Determinations • Data Entry • Verbal and Written Communication • Claim Amount Calculations • New Policies Processing • Eligibility Determination • Coverage Determination • Customer Service • Microsoft Office • Data Analysis

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