Andreka Styles
Stone Mountain
Summary
Accomplished Claims Benefit Specialist enhancing claim processing efficiency and customer satisfaction. Expert in claims analysis, problem-solving, Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Demonstrating exceptional communication and confidentiality handling, significantly reducing claim backlogs and improving system efficiency. Willingness to take on added responsibilities to meet team goals.
Overview
12
12
years of professional experience
Work History
Claims Benefit Specialist
CVS Healthcare
05.2020 - Current
- Provided exceptional customer service by addressing client inquiries promptly and professionally.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Resolved complex claims issues for improved customer satisfaction and reduced claim backlog.
- Conducted comprehensive audits to identify areas of improvement within the claims process, leading to a more efficient system.
- Maintained a high level of accuracy when inputting data into internal databases, ensuring all information was readily available for review by other team members as needed.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Maintained up-to-date knowledge on industry regulations and guidelines, ensuring compliance throughout the claims process.
Claims Service Representative
Teleperformance USA
06.2016 - 04.2020
- Enhanced customer satisfaction by efficiently processing and resolving claims in a timely manner.
- Provided exceptional customer service by addressing concerns, answering questions, and explaining complex policy information to clients.
- Actively contributed ideas during team meetings aimed at enhancing overall department efficiency and effectiveness.
- Demonstrated strong negotiation skills in settling disputes between insured parties and third-party claimants fairly while protecting company interests.
- Developed in-depth understanding of insurance policies and procedures.
- Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
Claims Customer Service Representative
MCI Communications
03.2012 - 05.2016
- Reduced errors in claim submissions by providing clear guidance to policyholders on required documentation and information needed for processing.
- Ensured accurate documentation and record-keeping, adhering to company policies and industry regulations.
- Enhanced customer satisfaction by efficiently resolving claims and addressing policyholder concerns.
- Streamlined claims processing for quicker resolutions, utilizing thorough investigation techniques and attention to detail.
- Gained valuable insights into customer needs through active listening skills, enabling tailored recommendations for additional coverage options that align with their specific requirements.
Education
GED -
Albany Technical College
Albany, GA06.2010
Skills
- Claims analysis
- Microsoft Office
- Claim investigation
- Confidentiality handling
- Time Management
- Problem-solving abilities
- Multitasking Abilities
- Organizing and Prioritizing Work
- Excellent Communication
- Adaptability and Flexibility
- Data Entry
- Customer Support
- Call Center Customer Service
- Communicating with clients
- Gathering information
- Payment Processing
- Product Knowledge
- Database Research
- Sales closing
- MS Outlook
Timeline
Claims Benefit Specialist
CVS Healthcare
05.2020 - Current
Claims Service Representative
Teleperformance USA
06.2016 - 04.2020
Claims Customer Service Representative
MCI Communications
03.2012 - 05.2016
GED -
Albany Technical College