Care Representative Claims Specialist
Resume:
Rhonda Burgess
Columbus, OH *****
*************@*****.***
Caring and friendly claims specialist with experience in health, auto, property insurance, financial services, consumer and commercial retail. I have over 6 years of claims experience in auto claims handling property damage, liability determinations, settlement negotiations, total loss, medical and bodily injury claims. Able to rapidly gain product knowledge with exceptional listening and analytical skills. I am currently licensed for property and casualty claim handling in Florida, South Carolina, North Carolina, Delaware and Kentucky.
Work Experience
Claim Specialist I
Nationwide Insurance Company - Remote
January 2022 to Present
● Investigate and determine liability on auto claims
● Review coverage issues to resolve and qualify in order to further process claim or deny
● Maintain team lowest average pending count for 4 months straight.
● Provide excellent customer service due to prompt, courteous and efficient response time. Customer Relations Specialist
BMW Financial Services - Hilliard, OH
June 2021 to December 2021
● Exceeded quantitative metrics on customer satisfaction, retention and inquiry volume.
● Grew existing customer accounts by 20% through exceptional customer service and effective sales techniques.
● Quickly triaged incoming calls and escalated calls when necessary, reducing average time by 15% Customer Care Representative
Molina Healthcare - Westerville, OH
February 2020 to May 2021
● Handled an average of 95 customer inquiries and complaints per day with a 95% customer satisfaction rate.
● Maintained a knowledge base of new product offerings and improved customer retention by proactively recommending new products to existing customers.
● Provided customer feedback and internal compliance feedback to management.
● Thoroughly documented customer interaction to reduce on-boarding when new customer service representatives interact with customers.
Call Center Quality Analyst
JCPenney Logistics - Columbus, OH
February 2018 to February 2020
● Listened to calls either recorded live or side-by-side while communicating feedback
● Conducted and evaluated customer feedback services.
● Understood the priority of the organization and evaluated call behaviors for regulatory compliance cross-selling and adherence to policy.
● Identified calls failing to meet predefined standards and identified the problem. Substitute Teacher
Columbus Public Schools - Columbus, OH
November 2012 to November 2017
● Worked as a substitute teacher from pre-k through 12 th grade as a substitute teacher Transmission Load Research Analyst
AEP - New Albany, OH
● Responsible for compiling metered load data from CSP, KY, and OH power plants for monthly wholesale billing accounts.
● Researched accuracy on load data from comparing historical data and correcting any load offsets
● Operated daily PJM/CEAS process through SAS program to generate daily load numbers for billing
● Worked closely with partner energy suppliers Buckeye Power, Appalachian Power, Duke Energy to obtain consistently accurate load count.
Education
MA in Accounting
University of Phoenix
October 2012 to October 2012
BA in Psychology
Hampton University
December 1998 to December 1998
Skills
• Insurance verification
• Medical records
• ICD coding
• ICD-9
• Organizational skills
• Medical terminology
• ICD-10
Certifications and Licenses
Property & Casualty License
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