Customer Service & Claims Specialist with 5+ Years Experience
Resume:
Domonique Fulton
Organized and enthusiastic customer service professional with over 5 years of
experience processing payments, handling insurance claims, maintaining customer records, and delivering excellent customer support. Skilled in medical terminology, claims processing, HIPAA compliance, and customer relationship management.
Blythewood SC, 29016
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EXPERIENCE
Customer Service Advocate BlueCross BlueShield Mar 2025 – May 2026
● Navigated complex medical information and ensured claims were processed accurately.
● Verified member eligibility and explained benefits to customers.
● Reviewed contracts and policies while resolving customer concerns.
● Providing accurate information regarding Patients Benefits/ Eligibility
& Claims.
Claims Investigator North Highland Oct 2023 – Jan 2025
● Investigated and evaluated insurance claims and customer coverage.
● Processed claims accurately while maintaining detailed records.
● Investigates, evaluates, and settles insurance claims (health, or liability) by reviewing policies, gathering evidence, and communicating with policyholders and legal counsel. Call Representative Sirva Jan 2021 – 2023
● Provided customer support regarding moving and storage services.
● Handled billing inquiries and maintained company systems knowledge.
● Responded promptly to customer emails and phone inquiries. Senior Sales Associate Harbor Freight Tools Apr 2021 – Oct 2021
● Assisted customers with merchandise selection and checkout transactions.
● Trained and mentored new employees.
● Managed store opening and closing procedures.
Call Representative Teleperformance Nov 2018 – May 2020
● Provided customer care, technical support, and customer acquisition.
● Documented customer interactions and troubleshot equipment issues.
● Answered high-volume inbound calls using phone etiquette, resolved eligibility questions for members accurately. SKILLS
Customer Service
Claims Processing,
Medical Terminology
Insurance Claims
Appointment
Scheduling,
CRM Software
HIPAA Compliance
Payment Processing
Data Management
Problem Solving
Team Collaboration
LANGUAGES
English
EDUCATION
Westwood High School, Blythewood, SC — High School Diploma
Aug 2013 - May 2015
Miller Motte Technical College Conway, SC — Certificate in Medical Billing & Coding
August 2020 - June 2022
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