Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
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Breanna L. Stephens

Breanna L. Stephens

Eastpointe,MI

Summary

Detail-oriented Examiner with 11 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and claims adjustment handling. Very skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Solid abilities in developing objectives and strategies to settle claims. Excellent skills compiling, coding, categorizing and auditing information to process claims.

Overview

15
15
years of professional experience

Work History

Long Term Disability Claims Examiner

Prudential
10.2022 - Current
  • Job duties include: The Disability Claims Examiner manages assigned caseload of more complex disability cases
  • Evaluates claimant eligibility
  • Utilizes specialty consulting resources effectively including medical legal vocational and/or rehabilitative staffs to achieve optimum outcomes for claims direction
  • Interacts with internal and external customers including but not limited to claimants employers physicians attorneys and underwriters to gather the information to make the decision on the claim
  • Analyzes approves or denies Disability Income and Waiver of Premium claims for contestable and non-contestable cases
  • Provides technical direction to other claims personnel as needed
  • Decides payment period follows up and monitors payment accuracy and timeliness; follows plan to closure.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Examined claims forms and other records to determine insurance coverage.

Short Term Disability Examiner (remote)

Reliance Standard Life Insurance Company
10.2021 - 10.2022
  • Assisted with company contracts, building claims, medical documentation, and checking on the well-being of our employees and their ability to carry out job functions
  • Handled employee’s payroll and disability funds.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Examined claims forms and other records to determine insurance coverage.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.

Disability Examiner

Sedgwick
01.2012 - 10.2021
  • Job duties include: Customer service and filing documents
  • Assisted with company contracts, building claims, medical documentation, and checking on the well-being of our employees and their ability to carry out job functions
  • Handled employee’s payroll and disability funds.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Examined claims forms and other records to determine insurance coverage.

Tax Professional

H&R Block
09.2010 - 03.2012
  • Job duties include: filing tax returns, answering telephones, filing paperwork, and servicing customers.

Financial Aid Assistant

University of Michigan
12.2008 - 02.2012
  • Job duties include: answering telephones, setting appointments with Financial Aid Advisors, filing
  • Documents, inputting information on Oracle Banner and Image Now systems, and assist with mail
  • Campaigns and events.

Education

Cosmetology - Cosmetology

Paul Mitchel The School, Heights
Madison Heights, MI
05.2017

Criminal Justice

University of Michigan
Dearborn, MI
2012

High School Diploma -

Marvin L. Winans Academy of Performing Arts
Detroit, MI
2008

Skills

  • Litigation Management
  • Secure Data Practices
  • Great Mathematical Skills
  • Medical Records Management
  • Reserves Recommendations
  • Customer Satisfaction
  • New Product Information
  • Customer Experience
  • Performance Feedback
  • Customer Inquiries
  • Report and Records Review
  • Medical Consultation
  • Service Delivery
  • Service Quality
  • Customer Needs Assessments
  • Policy Requirements and Eligibility
  • Workers' Compensation Claims
  • Premium Calculations
  • Case Notes
  • Rules of Evidence
  • Insurance Terminology
  • Policy Update Coordination
  • Customer Support
  • Account Changes
  • Payment and Investigation Escalations
  • Call Control
  • Amount Calculation
  • Sourcing and Compiling Information
  • Microsoft Office
  • Claims Evaluations
  • Automobile Claims Specialist
  • Determine Coverage
  • Insurance Coverage Limits
  • Insurance Calculation
  • Familiar with Fraud Statutes
  • Outbound Calls
  • Team Meetings
  • Corporate Policies and Procedures
  • Analyzing Details
  • Authorize Payments
  • Electronic Authorization Processing
  • Client Service
  • Account Management Expertise

Additional Information

  • HONORS AND ACTIVITIES , Employee of the month

Timeline

Long Term Disability Claims Examiner

Prudential
10.2022 - Current

Short Term Disability Examiner (remote)

Reliance Standard Life Insurance Company
10.2021 - 10.2022

Disability Examiner

Sedgwick
01.2012 - 10.2021

Tax Professional

H&R Block
09.2010 - 03.2012

Financial Aid Assistant

University of Michigan
12.2008 - 02.2012

Cosmetology - Cosmetology

Paul Mitchel The School, Heights

Criminal Justice

University of Michigan

High School Diploma -

Marvin L. Winans Academy of Performing Arts

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Breanna L. Stephens