Bonnie Bee
Spokane Valley,WA
Overview
5
5
years of professional experience
Work History
Claims Adjuster
Premera Blue Cross Of Washington
Spokane, WA
09.2016 - 02.2020
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation
- Identified potential fraud indicators
- Maintained compliance with all state regulatory requirements through proper documentation
- Achieved cost savings through successful subrogation efforts
- Contributed to a positive work environment through active participation in team meetings and collaborating on team projects
- Achieved high customer satisfaction for the company by providing correct and timely processing of all claims
- Attended corporate conferences and workshops to stay current on trends and developments within the field of claims adjusting.
- Verified insurance claims codes to determined if proper amounts were billed and paid
- Considered policy holder and company to fairly process all claims
- Evaluated coverage accurately by interpreting complex insurance policies
- Consistently met or exceeded times and goals expected of me
- Assisted any coworker needing guidance or help with any claim
- Ask questions when policies or procedures were unclear
Customer Service Representative
Premera Blue Cross Of Washington
Spokane, WA
09.2014 - 09.2016
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Addressed customer inquiries to ensure satisfaction and foster positive service experience.
- Analyzed customer service metrics to identify trends and develop strategies for improvement.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
- Enhanced customer loyalty by offering personalized solutions tailored to individual needs.
- Participated in training programs to enhance product knowledge and customer service skills.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Investigated and resolved customer inquiries and complaints quickly.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Sought ways to improve processes and services provided.
- Followed-through on all critical inter-departmental escalations to increase customer retention rates.
- Identified and resolved discrepancies and errors in customer accounts.
Education
Medical Billing & Coding
SCC
Spokane, WA06.2014
AAS - General Studies
SCC
Spokane, WA06.1997
Skills
- Claims Investigation
- Highly motivated
- Claims Processing
- Advanced oral and written communication skills
- Insurance policy coverage knowledge
- Policy Interpretation
- Regulatory Compliance
- Policy investigations
- Accident scene investigations
- Data Analysis
- Familiar with fraud statutes
- Medical Coding
- Critical Thinking
- Customer service and support
- Computer Skills
- Active Listening
- Team Collaboration
- Claims adjustment
- Decision-Making
- Claims
- Team Training
- Payment Processing
- Coaching and Mentoring
- Records Review
- Client Interviewing
- Litigation Management
- Denied claims identification
- Coverage Assessment
- Benefits review
- Accredited Claims Professional
Timeline
Claims Adjuster
Premera Blue Cross Of Washington
09.2016 - 02.2020
Customer Service Representative
Premera Blue Cross Of Washington
09.2014 - 09.2016
Medical Billing & Coding
SCC
AAS - General Studies
SCC