Customer Service Human Resources

Makrissa Banks

Culpeper, Va *****

202-***-**** ************@***.***

PROFESSIONAL SUMMARY

Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines.

SKILLS

• TPA Experience

• Microsoft Office Proficient

• Excellent Written Skills

• Customer Service Skills

• Verbal Skills

• Understanding Medical Records

• Relationship Building Skills

• Scheduling

• Claims Experience

• Office Management

• Money Management

• Human Resources

• Negotiation

• Independent Worker

• Mentoring

• Training

• Project Management

• Time Management

• Workers' Compensation

• Detailed Orientated

• Problem Solver

• Customer Service Ski;;s

• Leadership

• 1st & 3rd Party Claims Handling

• File Reviews

• Analysis skills

• Recruiting & Training

• Audit Review

• Management

• Claims Management

• Confidential Management

• Integrity

• Investigation Skills

• File Management

• Critical Thinking Skills

• Organizational Skills

• Organization& Time Management

• Documentation Abilities

WORK HISTORY

CLAIMS PROCESSOR 12/2021 to Current

Sedgwick - Baltimore, MD

• Review injury claims and evidence

• Decide to accept or deny the claim

• Review detailed investigation notes

• Pay worker's compensation payments

• Process appointments for review medical necessity

• Confirm claims filed with the worker’s compensation commission

• Review documents and evidence

• Issue payment for medical bills and loss wages

• Documents treatment obtained

• Confirm if the claim is compensable

• Speak with law about litigated claims

• Make settlement offers once treatment completed

LIABILITY CLAIMS SPECIALIST 11/2020 to 12/2021

CorVel Corporation - Rockville, MD

• Investigate claims

• Monitor claims in litigation

• Review documents and evidence

• Obtain statements

• Make detailed recommendations to pay claim

• Issue payments and send out releases

• Pay or deny claims in writing

• Negotiation and settlements

• Monitor reports from the Office of Commonwealth Attorney and Maryland Judicial case search.

CLAIMS REPRESENTATIVE 03/2019 to 11/2021

Allstate Insurance - Elkridge, MD

• Investigate complex claims that involve disputes

• Research medical bills and records and injury background histories for injury claims

• Obtain recorded statements

• Interact with policyholders, claimants, medical providers, body shops and attorneys

• Verify employment and issue loss wage payments

• Verify facts of the accident, review supporting case files, and negotiate settlements

• Issued payments for bodily injury claims

• Negotiate bills and settlements

• Pay medical liens

• Negotiation and handle Medicare, Medicaid and Tricare, Workers Compensation liens

• Review medical bills and records

• Understand policy and auto contracts in Maryland, Virginia, District of Columbia, Pennsylvania, and Delaware

TELEPHONE CLAIMS REPRESENTATIVE 01/2014 to 11/2018 GEICO - Fredericksburg, VA

• Investigate complex claims that involve disputes

• Obtain recorded statements

• Interact with policyholders, claimants, medical providers, body shops and attorneys

• Verify employment and issue loss wage payments

• Verify facts of the accident, review supporting case files, and negotiate settlements

• Conduct claim file audits

• Mentor peers and provide feedback

• Complete training sessions

• Hold live monitoring trainings

CUSTOMER SERVICE REPRESENTATIVE 07/2013 to 12/2014 GEICO - Fredericksburg, VA

• Investigate complex claims that involve disputes

• Obtain recorded statements

• Interact with policyholders, claimants, medical providers, body shops and attorneys

• Verify employment and issue loss wage payments

• Verify facts of the accident, review supporting case files, and negotiate settlements

• Take the first initial report of a loss

• Transfer files accordingly to claims adjusters

• Answer questions about automobile claims inquires

• Obtained an adjuster’s license to determine automobile accidents liability

• Educate policy holders about their coverage's and how they work doing an automobile accident

• Attach files and necessary documents to claims so they can be handled completely

• Issue payments for personal injury claims or medical payment claims. OFFICE SERVICES ASSISTANT 09/2012 to 06/2013

District, Parole & Probation Office - Charlottesville, VA

• Provides clerical and administrative support to Probation and Parole Services' staff by keying reports and correspondence from draft and collection of data to input into the system

• Maintaining files, greeting, and assisting visitors and setting up new clients in the database

• Recruiting and assisting with onboarding with new hirers

• Performs keyboarding duties, entering data in agency data systems and fiscal support duties

• Providing customer service and administrative support in a professional office setting including data entry, filing, and preparing correspondence

• Demonstrates skills in the use of Microsoft Office to include Word, Access, and Excel to accomplish office support requirements

• Experience using office equipment (i.e., Computers, printers, copier, and fax machine)

• Ability to interpret and follow oral and written rules and regulations

• Working experience using a multi-line communication system and collecting data to create a file for new clients.

INSURANCE AGENT 09/2010 to 09/2012

GEICO - Fredericksburg, VA

• Obtain insurance license for several different states

• Provide excellent customer service

• Take payments

• Reissue policies that are cancelled

• Retain policy holders

• Handle request mail paperwork, email documents, etc.

• Helping the customers by responding to incoming phone inquiries

• Answering their questions and meeting all their policy changes and needs

• Educate our policyholders understand the coverage they have or need

• Offer additional products and services.

EDUCATION

Strayer University - Rockville, MD Bachelor of Arts Human Resource Management, 12/2020

Strayer University - Manassas, VA Associate of Arts Arts in Business Administration, 05/2011

Culpeper County High School - Culpeper, VA Diploma 6/1995

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