Customer Service Claims Specialist

Smithville, TN 371**-***-***–**** ************@*****.***

Lisa Puckett

Organized and results-oriented Agent with 7+ years of experience developing leads, exceeding agency goals, and building long-term customer relationships. Dedicated Customer Service Specialist with 14+ years' experience with customer retention and meeting all customers' needs. 3+ years' experience coordinating Agency events, marketing in the local community, and working closely with Agent executing email campaigns that boosted overall sales to ensure Ambassador and Chairman Circle goals were met. (Coveted top 1% of Agents achieve this annually). Proven ability to work under pressure in a demanding job setting by providing excellent customer service and ability to quickly identify solutions to any obstacles that may arise. Focused and dedicated to achieving high standards of service for each job I am tasked with. Skills

Receptionist (16+ yrs)

Medical Scheduling (13+ yrs)

Medical Records (13+ yrs)

Bookkeeping/ Bank Deposits

(3+ yrs)

Insurance verification (16+

yrs)

Claims Specialist (3+ yrs)

Customer Service Skills (16+

yrs)

Customer Support (16+ yrs)

Microsoft Office, Excel,

Outlook, (16+ yrs)

Insurance Scheduling (3+

yrs)

Employment History

State Farm Mallory Pfingstler, Smithville, TN — Receptionist/Claims Specialist Mar 2021 - Oct 2024

● Alias VABSOR

● Process all payments, fax paperwork to appropriate businesses

● Reconciled bank statements with financial records to summarize banking and business operations using Excel

● Schedule all appointments for the office and all Agents using Outlook

● Pay all office bills and prepare checks for the Agent using QuickBooks

● Claims specialist for the office

● Prepare all onboarding letters/documents to mail to new customers

● Greet visitors warmly, manage multi-line phone systems, and coordinate schedules. Streamline office processes, resulting in improved efficiency and visitor satisfaction.

● Maintain meticulous records, organize files, and handle confidential information with utmost discretion. Implement a new filing system, enhancing document retrieval speed.

● Work closely with various departments to facilitate smooth communication. Assist in event planning and execution, fostering a positive work environment.

● Manage incoming correspondence, prioritize tasks, and meet tight deadlines. Reduce wait times and enhance visitor experience through efficient queue management.

● Streamlined customer service processes, reducing response times and enhancing policy management efficiency while maintaining meticulous financial records.

● Continuously improve processes to enhance efficiency and customer satisfaction.

● Provide comprehensive customer support, guiding clients through auto and fire claims processes. Ensure seamless service delivery and maintain strong client relationships.

● Manage a diverse insurance portfolio including auto, home, life, health, and specialty products. Ensure meticulous attention to policy details and customer requirements.

● Lead customer care initiatives, driving satisfaction through tailored service strategies. Oversee team performance, implement training programs, and streamline claim processes.

● Office Billing Specialist

Murfreesboro Medical Clinic (MMC), Murfreesboro, TN — Receptionist Jan 2019 - Mar 2021

● Answered inbound phone calls and assisted patients with any requests or questions

● Proficiently navigated GroupCast to schedule appointments, update and verify patient information, medical records and communicate with doctors, nurses, and patients

● Made referral and follow up appointments in a timely manner

● Checked patients out as the final step of their appointment process

● Effectively recorded messages and distributed them to the proper channel

● Made specialty appointments for MRI, CT, Ultrasounds, and lab work Family Medical Center, Smithville, TN — Receptionist/Assistant May 2008 - Nov 2018

● Answered reception phones and assisted callers with any requests or questions

● Scheduled patient appointments

● Proficiently navigated Intergy to schedule appointments, process payments, update and verify patient information, medical records, refill electronic prescriptions and communicate with doctors, nurses, and patients

● Efficiently entered and updated patient information and medications into system with a sharp attention to detail

● Worked with Insurance Company, PHarmacy and Doctor to obtain required documentation for Prior Authorizations

● Clearly communicated progress, problems and risks to upper management

● Resolve scheduling conflicts when unforeseen issues occurred

● Took payments based on insurance requirements

● Effectively recorded and prioritized messages from pharmacies, doctor offices, hospitals, insurance companies, and patients and distributed them to the proper channels based on priority

● Faxed all doctor approved orders, prescriptions, and medical records to hospitals, pharmacies, attorneys offices, insurance companies, government offices, specialty clinics and other requested facilities in a timely manner

● Controlled Substance Monitoring Database (CSMD)

● Worked with specialty medical facilities to schedule new patient appointments and provided required documentation

● Assisted nurse or doctor in room during patient visits upon requests

● Greeted patients and assisted with clinic check-ins

● Maintained organized environment by updating necessary paperwork, filing charts, and notifying nurses or patient arrival

Education

Associate’s Degree

MTSU Murfreesboro, TN 1984 - 1986

References

Josh Emberton State Farm Claims Specialist : 615-***-**** Kellie Williams State Farm Mallory Pfingstler - Office Manager : 615-***-****

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