Brandon Hayes
Hinesville,GA
Summary
Detail-oriented healthcare claims and customer service professional with years of experience in claims resolution, provider communication, customer support, documentation, and operations. Proven ability to review and resolve claims efficiently, maintain 98% accuracy, gather missing information, and communicate effectively with providers and customers. Experienced in working remotely, managing high-volume workloads, documenting interactions, and resolving complex issues while maintaining strong service standards. Former U.S. Army logistics professional with demonstrated leadership, organization, and operational coordination skills.
Overview
15
15
years of professional experience
Work History
Provider Customer Services for Claims
Cigna Health
10.2023 - Current
- Manage healthcare claim resolution while ensuring timely settlements in accordance with service standards and established procedures.
- Review claims and identify missing or incomplete information required for accurate and timely processing.
- Prepare and distribute Provider Missing Information Return Forms according to provider communication preferences.
- Maintain 98% accuracy through thorough documentation, attention to detail, and efficient claims-processing practices.
- Execute comprehensive provider communication strategies to obtain necessary information and improve claim settlement efficiency.
- Communicate professionally with healthcare providers to clarify claim-related issues and facilitate resolution.
- Maintain accurate records and documentation to support claim processing, follow-up, and resolution.
- Prioritize multiple claims and provider requests while meeting productivity, quality, and turnaround-time expectations.
Customer Service Associate
Target
01.2020 - 01.2023
- Handled customer inquiries, orders, returns, and service requests in a high-volume customer service environment.
- Resolved customer complaints professionally while maintaining composure and delivering timely solutions.
- Provided customers with accurate information regarding products, pricing, promotions, orders, and services.
- Identified opportunities for upselling and cross-selling products while maintaining a customer-focused approach.
- Managed multiple customer needs simultaneously while maintaining accuracy and service quality.
- Worked collaboratively with team members to resolve customer issues and maintain efficient operations.
Customer Support Specialist
The Home Depot
Hinesville, USA
01.2015 - 01.2020
- Responded to customer inquiries through phone, email, and chat while providing accurate and timely information.
- Provided troubleshooting assistance and guided customers through products, services, and technical processes.
- Resolved customer concerns by identifying issues, researching solutions, and providing appropriate next steps.
- Maintained comprehensive documentation of customer interactions within the CRM system to ensure accurate records and support future service needs.
- Collaborated with team members to resolve complex customer issues, achieving an 80% resolution rate.
- Followed up with customers to confirm satisfaction and identify opportunities to improve the customer experience.
Petroleum Supply Specialist
United States Army
Fort Stewart, USA
01.2012 - 01.2015
- Managed petroleum supply chain operations, including the receipt, storage, accountability, and distribution of petroleum products.
- Coordinated logistical support for multiple missions while ensuring timely delivery of fuel and supplies.
- Maintained accurate operational records and followed established safety, accountability, and organizational procedures.
- Coordinated resources and personnel to support operational readiness and mission requirements.
- Trained and supported team members to ensure compliance with organizational standards and improve operational efficiency.
- Demonstrated strong leadership, attention to detail, teamwork, and problem-solving skills in a demanding environment.
Education
Bachelor’s Degree - Human Resource Management
Skills
- Healthcare Claims Processing
- Claims Resolution & Research
- Provider Customer Service
- Missing Information Requests
- Insurance & Benefits Support
- Documentation & Data Accuracy
- Customer Relationship Management (CRM)
- Problem Solving & Issue Resolution
- Provider Communication
- Remote Customer Support
- HIPAA & Confidential Information
- Workflow Optimization
- Quality Assurance
- Team Collaboration
- Logistics & Operations
- Microsoft Office
Additional Qualifications
- Experienced in remote work environments
- Strong written and verbal communication
- High attention to detail and accuracy
- Experienced handling confidential customer and healthcare information
- Strong organizational and time-management skills
- Comfortable working with multiple systems and applications
- Proven ability to meet performance and service-level standards
Timeline
Provider Customer Services for Claims
Cigna Health
10.2023 - Current
Customer Service Associate
Target
01.2020 - 01.2023
Customer Support Specialist
The Home Depot
01.2015 - 01.2020
Petroleum Supply Specialist
United States Army
01.2012 - 01.2015