Claims Processor Customer Service
Resume:
T
Juanita Thomas
***************@*****.***
Zebulon, United States 27597
SUMMARY
Seasoned Claims Processor evaluating online entry, error correction and quality control review for final adjudication of claims. Strong business and financial acumen with proven success to maintain efficient operations. Extensive knowledge of billing, collections and fiduciary management. Detailed Claims Processor with 7 years of experience investigating claim information for correctness. Trustworthy teammate with benefit knowledge and rapport-building skills. Noted for thoroughness and ethical customer service.
SKILLS
Payments posting
Transaction reconciliation
Claims review
Regulatory compliance
EXPERIENCE
Claims Processor
Wake Forest, NC
Moving and Storage Company/ Apr 2013 to Current
Verified claim data correctness in preparation for processing.
Reviewed history records to determine benefit eligibility for services.
Maintained comprehensive database for enrollment data, claim submission and payment information.
Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
Technical Customer Support Specialist
Wake Forest, NC
Moving and Storage Company/ Apr 2013 to Current
Provided customer service and issue resolution to increase QA satisfaction levels.
Engaged customers with proactive strategies to understand needs and develop successful solutions.
Educated clients on how to conduct transactions with convenient online solutions.
Expressed appreciation for patronage, inviting and encouraging customer return visits.
Answered support calls and emails from corporate customers needing assistance with moving products.
Credit Specialist/Customer Service Manager
Raleigh, NC
Homebuyers Consulting Network/ Jun 2000 to Apr 2007
Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
Established positive rapport with customers, managers and customer service team members to maintain positive and successful work environment.
Maintained knowledge of company products and services to promptly resolve complaints and concerns.
Assisted staff with resolving complex customer issues and implementing targeted solutions.
Investigated sensitive customer service complaints and delivered prompt resolution to customer satisfaction.
Assisted customers in making payments on accounts and setting up payment plans.
Reviewed customer account information to determine current issues and potential solutions.
Interviewed, hired and trained new quality-focused customer service representatives.
EDUCATION AND TRAINING
Some College (No Degree): Business Administration And Management
Vance Granville Community College
Louisburg, NC
CERTIFICATIONS
Licensed Administrator in Training - 2018
Activity Coordinator 2019
Medication Technician 2017
CPR/First Aid 2021
Claims Adjusters License 2022
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