SHANICE LEWIS

Benton Harbor, MI *****

adza0y@r.postjobfree.com / 269-***-****

SUMMARY

Capable Claims Representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing 5 years of related experience. SKILLS

File Management

Team Collaboration

Settlement Negotiation

Time Management

Conflict Resolution

Accident Review

Decision Making

Problem-Solving

Credit Card Payment Processing

Data Entry

CRM Software

Multitasking and Prioritization

Customer Account Management

Call Documentation

Effective Written and Verbal Communication

Healthcare Knowledge

EXPERIENCE

Claims Associate / Liberty Mutual - Benton Harbor, MI 01/2022 - 01/2023 Organized information by using spreadsheets, databases or word processing applications. Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.

Processed claims for payment or forwarded to appropriate personnel for further investigation Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.

Drafted statements of loss to summarize payments, underlying policy coverages and damages. Claims Representative / GEICO - Benton Harbor, MI 06/2018 - 08/2021 Examined claims, records and procedures to grant approval of coverage. Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.

Prepared and reviewed insurance-claim forms and related documents for completeness. Examined automobile policies with third-party liability, accident benefits and collision benefits. Coordinated and planned investigations of claims to confirm compensability and coverage. Loan Specialist / Sallie Mae Student Loan Services - Indianapolis, IN 09/2017 - 05/2018 Answered customer inquiries involving rates, products and loan application status to facilitate quality customer service.

ensure all accounts are worked within company standards and federal regulations. assist with loan correction requests. correction request may require interest calculations, credit reporting disputes, payment adjustments, and other loan corrections.

Maximized company profitability with appropriate pricing of new loan originations, fee income and selling of SL

products and services.

Collected past due loans, keeping credit and collateral exceptions within policy ranges. Provider Enrollment Specialist / Conduent - Indianapolis, IN 05/2017 - 09/2017 Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations. Supported members through navigation of enrollment process to facilitate optimal decisions. Kept watchful eye on physician expiration dates and contacted practitioners to inform when such dates were near. Followed up with insurance carriers to address and rectify denied claims. Granted, modified, denied, or terminated assistance based on key information and eligibility determination. EDUCATION AND TRAINING

High School Diploma

Benton Harbor High School - Benton Harbor, MI

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