Senior Claims Operations Leader with 20+ Years Experience

TYRONE CURETON

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PROFESSIONAL SUMMARY

Strategic Multi-Line Claims Supervisor with 20+ years of experience leading complex claims operations, high-volume customer service teams, and regulatory compliance processes. Demonstrated success in managing cross-functional teams to increase claim resolution rates by 20% and reduce processing errors by 25%. Proven leader with expertise supervising up to 15 professionals, streamlining workflows, optimizing operational efficiency, and delivering exceptional customer experiences in fast-paced call center and insurance environments.

SKILLS

• Excellent written and verbal communication • Claims Understanding

• Expense Control • Call Center Transactions

• Customer Experience • Corporate Social Responsibility

• Information Updates • Claims Analysis

• MS Office Suite • Internal Control Systems

• Claims Investigation and Research • Customer Expectations Management

• Past Due Account Management • Client Rapport-Building

• Claims Auditing • Property Adjusting

• Maintaining Quality Assurance Standards • Insurance Policy Review

• Effective Customer Service • Inputting Claims

• Claims Adjustments Review • Cost Control and Reduction

• Professional Telephone Demeanor • Problem-Solving Ability

• Office Equipment Proficiency • Call center transactions WORK HISTORY

06/2023 - 04/2025

Lead Customer Service

Toll Brothers - Philadelphia, PA

• Led the insurance claims process with empathy, increasing customer satisfaction metrics.

• Investigated, evaluated, and adjusted multi-line claims in accordance with legal standards.

• Documented financial controls, improving claim accuracy by 20%.

• Oversaw sensitive data updates and managed the appeals workflow. 12/2021 - 05/2023

Medical Records File Clerk

Center City Legal - Philadelphia, PA

• Managed HIPAA-compliant filing systems and accurately coded clinical data.

• Processed and abstracted patient information for legal and medical documentation.

• Improved office efficiency through digitization initiatives and effective documentation management Customer Service Supervisor

Glenside, PA 19038 267-***-**** *************@*****.*** Independence Blue Cross Blue Shield - Philadelphia, PA 03/2018 - 12/2021

• Supervised a team of 10+ representatives, increasing customer satisfaction scores by 20%.

• Reduced average handling time by 15% through effective escalation management and targeted coaching.

• Led compliance-focused training programs to improve adherence to policies and overall team performance. 01/2011 - 03/2018

Customer Service Specialist

Independence Blue Cross Blue Shield - Philadelphia, PA

• Delivered one-call resolution for hundreds of customer inquiries weekly.

• Assisted with claims submission and issue resolution, maintaining 98% accuracy.

• Educated clients on benefits access, system navigation, and required documentation. 05/2008 - 01/2011

Customer Service Consultant

Independence Blue Cross Blue Shield - Philadelphia, PA

• Handled website chats and calls, providing product and eligibility expertise.

• Audited applications and strengthened documentation compliance.

• Shared insights with leadership to improve call center efficiency. 03/2000 - 05/2008

Primary Account Coordinator

Independence Blue Cross Blue Shield - Philadelphia, PA Served as a liaison between high-priority accounts and internal departments to ensure timely issue resolution.

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• Resolved discrepancies while managing sensitive insurance and client data with strict confidentiality.

• Contributed to increased client retention through responsive, solutions-focused customer service. EDUCATION

05/2023

Associate of Science: Business Administration And Paralegal Studies Pierce College - Philadelphia, PA

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