Brian Spight
Glendale,AZ
Summary
Experienced Senior Claims Adjuster and Customer Service Professional with over 30 years of expertise in claims processing, insurance policies, and client relations. Proven leadership in training, mentoring, and managing high-volume claims environments. Adept at analyzing complex claims, ensuring compliance, and delivering exceptional service to Fortune 500 clients.
Overview
24
24
years of professional experience
Work History
Employee Engagement Coordinator
UKG
Scottsdale, Arizona
08.2025 - 01.2026
- Provide best-in-class customer service skills with a proactive approach to create exceptional customer satisfaction.
- Work in a call center environment.
- Serve as the first point-of-contact for employees, addressing inquiries related to payroll and benefits enrollment.
- Learn and navigate Payroll and Benefits systems to effectively respond to end-user needs.
- Utilize various platforms including phone, email, and CRM systems to provide stellar support.
- Analyze issues to determine root causes and generate effective solutions.
Claims Adjuster / New Day Claims Specialist
United Healthcare
Phoenix, USA
11.2014 - 05.2025
- Managed and processed over 35 insurance claims daily, ensuring accurate coverage assessment and fraud investigation.
- Reviewed and adjudicated insurance claims, verifying coverage and medical documentation.
- Investigated potential fraudulent claims, contributing to loss prevention.
- Maintained and updated claims data across multiple online systems including Facets, Citrix, and Macess.
- Provided expert guidance to insureds and providers, facilitating positive claim outcomes.
- Evaluated medical policies to determine appropriate liability and coverage.
Enrollment Specialist
United Healthcare
Phoenix, USA
11.2011 - 11.2014
- Enrolled members into health and wellness programs, providing detailed case management and support.
- Communicated health program options via inbound and outbound calls.
- Secured and processed enrollment data using UHC systems.
- Provided case updates and support to members, enhancing engagement and satisfaction.
Customer Service Representative
Massachusetts Medical Society / Hollister Associates
Waltham, USA
01.2011 - 05.2011
- Supported customer inquiries regarding medical publications, ensuring seamless access and information delivery.
- Responded to subscriber and agent inquiries about publications and web services.
- Provided product information and resolved online access issues.
- Demonstrated extensive knowledge of medical publications and customer support systems.
Client Service Representative
Broadridge / OfficeTeam
Peabody, USA
08.2010 - 11.2010
- Managed client inquiries related to global proxy services, ensuring timely and accurate responses.
- Responded to internal and external client inquiries efficiently.
- Acted as liaison for printed materials and internal departments.
- Performed additional duties as assigned to support client needs.
Small Group Specialist
American Community Mutual Insurance
Livonia, USA
01.2004 - 10.2009
- Processed group coverage changes and managed client communications for small business clients.
- Processed paperwork for plan modifications and group changes.
- Collaborated with agents and marketing teams to facilitate timely service.
- Handled group balance transfers and related administrative tasks.
Customer Service Representative II
Blue Cross Blue Shield of Michigan
Southfield, USA
03.2002 - 12.2003
- Provided claims and benefit support to customers and providers, ensuring accurate and timely resolution.
- Responded to inquiries regarding claims, benefits, and coverage.
- Conducted research to resolve complex issues and improve customer satisfaction.
- Nominated for Blues Service Fanatic Award for exceptional service.
Education
B.S. - Business Management
University of Phoenix
Skills
- Claims Processing
- Medical Coding (HCPCS)
- Customer Relationship Management
- Data Entry & Management
- Fraud Detection Techniques
- Benefits and Enrollment
- Call Center Expertise
- Microsoft Office Suite
- Claims Investigation
- Policy Analysis
- Team Training & Development
Accomplishments
- Received multiple 'Bravo' awards for teamwork and goal achievement.
- Recognized for organizing staff activities to enhance team camaraderie.
- Consistently maintained high accuracy and efficiency in claims review and processing.
Timeline
Employee Engagement Coordinator
UKG
08.2025 - 01.2026
Claims Adjuster / New Day Claims Specialist
United Healthcare
11.2014 - 05.2025
Enrollment Specialist
United Healthcare
11.2011 - 11.2014
Customer Service Representative
Massachusetts Medical Society / Hollister Associates
01.2011 - 05.2011
Client Service Representative
Broadridge / OfficeTeam
08.2010 - 11.2010
Small Group Specialist
American Community Mutual Insurance
01.2004 - 10.2009
Customer Service Representative II
Blue Cross Blue Shield of Michigan
03.2002 - 12.2003
B.S. - Business Management
University of Phoenix