Customer Service Claims Specialist
Resume:
Holley Cleary
Montgomery, AL
************@*****.***
Professional Summary
Dynamic and results-driven professional with extensive experience as a District Manager and Claims Specialist. Proven track record in leading teams to achieve operational excellence and drive revenue growth. Skilled in strategic planning,problem-solving,and fostering strong relationships with clients and stakeholders. Adept at analyzing complex claims,implementing innovative solutions,and enhancing process efficiencies. Committed to delivering exceptional service and achieving organizational goals through effective leadership and a customer centric approach. Work Experience
Claims Specialist
Delta Dental-Montgomery, AL
October 2023 to November 2024
Answered inbound calls from patients, doctor's offices, and insurance carriers Initiated payment plans for patients with outstanding balances Utilized multiple resources to resolve patient inquiries Maintained performance goals while implementing HIPPA. Educated members about their benefits and covered procedures Filed grievances for customers with negative experiences Resolved claims disputes, requests for clarification, and appeals in an efficient and timely manner District Manager
K&P Remodeling-Knoxville, TN
January 2023 to September 2023
Developed relationships with over 100 new staff members, and assisted many existing staff members in their career development
Trained store personnel on the company's products, services, customer service, and appreciation Managed a team of 16 sales representatives at 11 different locations across 2 states Designed and implemented a lesson plan to teach data mining Appointment Setter
Easy Rest Adjustable Beds-Baltimore, MD
November 2020 to December 2022
Made outbound calls to patients, doctor's offices, and insurance carriers Initiated payment plans for patients with outstanding balances Documented call outcomes in real-time
Answered patient inquiries and resolved issues efficiently Adapted to a structured training program to become proficient in processes Handled angry and frustrated callers with professionalism and empathy Education
High school diploma in General study Majored in English Literature Robert E Lee High School - Montgomery, AL
May 2006 to May 2006
Skills
• Documentation review
• Leadership
• Time management
• Customer service
• Communication skills
• Microsoft excel
• Microsoft word
• Computer literacy
• Training & Development
Assessments
Call center customer service — Proficient
January 2022
Demonstrating customer service skills in a call center setting Full results: Proficient
Customer focus & orientation — Completed
February 2022
Responding to customer situations with sensitivity Full results: Completed
Attention to detail — Proficient
November 2022
Identifying differences in materials, following instructions, and detecting details among distracting information
Full results: Proficient
Front desk agent (hotel) — Proficient
July 2022
Selecting hotel rooms based on requests and identifying errors in hotel data Full results: Proficient
Analyzing data — Proficient
July 2023
Interpreting and producing graphs, identifying trends, and drawing justifiable conclusions from data Full results: Proficient
Sales skills — Proficient
December 2022
Influencing and negotiating with customers
Full results: Proficient
Outside sales — Proficient
May 2024
Understanding and responding appropriately in sales scenarios, and performing common sales calculations
Full results: Proficient
Management & leadership skills: Impact & influence — Proficient July 2023
Choosing the most effective strategy to inspire and influence others to meet business objectives Full results: Proficient
Retail customer service — Proficient
October 2023
Responding to customer situations in a retail setting Full results: Proficient
Work motivation — Proficient
December 2022
Level of motivation and discipline applied toward work Full results: Proficient
Sales fit — Proficient
January 2024
Measures the traits that are important for success in sales positions Full results: Proficient
Work style: Conscientiousness — Proficient
June 2024
Tendency to be well-organized, rule-abiding, and hard-working Full results: Proficient
Patient-focused care — Proficient
June 2024
Responding to patient concerns with sensitivity
Full results: Proficient
Management & leadership skills: Planning & execution — Proficient January 2023
Planning and managing resources to accomplish organizational goals Full results: Proficient
Supervisory skills: Motivating & assessing employees — Proficient July 2023
Motivating others to achieve objectives and identifying improvements or corrective actions Full results: Proficient
Scheduling — Proficient
October 2024
Cross-referencing agendas and itineraries to avoid scheduling conflicts Full results: Proficient
Administrative assistant/receptionist — Proficient February 2022
Using basic scheduling and organizational skills in an office setting Full results: Proficient
Customer service — Proficient
November 2022
Identifying and resolving common customer issues
Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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