Adaisha Crossland
United States
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 10+ years of related experience. Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements. Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
10
10
years of professional experience
Work History
Claims Service Specialist
Allstate
Remote, TN
12.2022 - Current
- Reviewed and processed incoming claim documents for accuracy and completeness.
- Monitored the progress of claims to ensure timely resolution.
- Drafted statements of loss to summarize payments, underlying policy coverages and damages.
- Examined automobile policies with third-party liability, accident benefits and collision benefits.
- Assisted new policyholders with processing claims.
- Corresponded with insured or agent to obtain information or inform of account status or changes.
Workers' Compensation Claims Representative
NAVEX Global
*Remote, TN
10.2021 - 12.2022
- Maintained records of claim activities such as payments, denials, settlements and appeals.
- Evaluated medical reports for accuracy and completeness to support disability determinations.
- Provided timely responses to inquiries regarding the status of claims.
- Researched applicable laws, regulations and policies to ensure compliance with state and federal requirements.
- Assisted injured workers in understanding their rights under the Workers' Compensation Act.
- Communicated with various departments within an organization regarding claim updates.
Auto Claims Representative
American Auto Shield
Remote, TN
02.2021 - 10.2021
- Analyzed customer claims and determined coverage eligibility.
- Reviewed policy documents to ensure accuracy of information.
- Processed payments for auto insurance claims in a timely manner.
- Provided excellent customer service to claimants throughout the claims process.
- Assisted with resolving difficult or complex claims issues.
Unemployment Claims Specialist
State of Tennessee
*Remote, TN
07.2020 - 04.2021
- Assessed client information and prepared unemployment claims forms.
- Reviewed and verified accuracy of submitted documents.
- Provided guidance and assistance to claimants in completing applications.
- Identified fraud cases through detailed examination of claimant's documents.
- Resolved discrepancies between claimant's reported income and employer's reported wages.
Customer Service Representative
Enterprise Rent-A-Car
Remote, TN
07.2019 - 04.2020
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
Technical Support Representative
Asurion Call Center
Nashville, TN
09.2018 - 07.2019
- Provided technical assistance to customers through phone, email and chat support.
- Diagnosed system errors and implemented solutions to resolve them.
- Assisted customers with installation of new hardware and software applications.
Patient Care Advocate
Accredo Health
, TN
11.2015 - 08.2018
- Coordinated with other healthcare providers to ensure patient safety, continuity of care, and optimal outcomes.
- Collaborated with insurance companies to ensure coverage of necessary treatments or medications.
- Monitored changes in patient status and reported any concerns or issues to the primary care team for prompt resolution.
- Assisted with scheduling appointments or tests as needed by the patient's physician or specialist.
Client Relations Specialist
P & M Transportation
, TN
10.2013 - 02.2015
- Managed incoming inquiries from customers via phone, email and other communication channels.
- Processed invoices and payments accurately and promptly.
- Maintained customer accounts by recording account information, reconciling discrepancies.
- Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
Education
Nashville State Community College
Nashville, TN12-2025
Medical Assistant -
Concorde Career College
Memphis, TN02-2018
High School Diploma -
Bolton High School
Arlington, TN05-2014
Skills
- Insurance knowledge
- Policy Interpretation
- Confidentiality
- Claims Investigation
- Policy Knowledge
- Allocating claims
Accomplishments
- Promoted to leadership in multiple roles
- Received awards and recognition for outstanding customer experience.
Timeline
Claims Service Specialist
Allstate
12.2022 - Current
Workers' Compensation Claims Representative
NAVEX Global
10.2021 - 12.2022
Auto Claims Representative
American Auto Shield
02.2021 - 10.2021
Unemployment Claims Specialist
State of Tennessee
07.2020 - 04.2021
Customer Service Representative
Enterprise Rent-A-Car
07.2019 - 04.2020
Technical Support Representative
Asurion Call Center
09.2018 - 07.2019
Patient Care Advocate
Accredo Health
11.2015 - 08.2018
Client Relations Specialist
P & M Transportation
10.2013 - 02.2015
Nashville State Community College
Medical Assistant -
Concorde Career College
High School Diploma -
Bolton High School