Briana James
Centerville,OH
Overview
12
12
years of professional experience
Work History
Claims Specialist
CodeBlue
01.2019 - 02.2024
- As a claims process/specialist in this call center, I worked with customers, insurance companies, and contractors for homes that had been flooded or damaged during natural disasters. I would take initial claims, make sure contractors were dispatched quickly and efficiently, upload the contractors plan for restoring the home to livable again, and notate the plan of action to obtain this.
- I worked off three monitors one of which being a laptop, had a phone system connected, and was required to multitask via phone, email, and web chat while entering customer data into the system and making sure the customers were satisfied, helping in situations the customers were not satisfied, assisting contractors with the tools needed to repair the homes, and keeping in contact with the insurance companies to keep them updated.
Processing specialist
Assurant
01.2016 - 01.2019
- In this call center, I processed loans and worked with other mortgage companies, lenders, insurance agencies, and insurance agents to provide the best customer service to customers to ensure their home was always covered with insurance and to make sure their homeowners insurance was paid on time
- As a processing specialist, I worked with insurance companies and agencies to verify and collect information as needed and update the loans per information verified through insurance companies and agencies.
- I worked on multiple computer systems while processing these loans all to make sure deadlines were met and homeowner coverage was sufficient so that lender-placed insurance was not put into place
- This position also made sure customer support was handled through phone calls and emails.
Cashier/Customer Service/Sales Associate
Walmart SuperCenter
01.2012 - 01.2016
- When I worked at Walmart, I was a cashier, worked in health and beauty/pharmacy as a floor associate, and worked in lawn and garden as a floor associate as well
- I assisted customers with purchases at the register, stocked merchandise in health and beauty in pharmacy, and ran the register and stocked merchandise in lawn and garden as well
- I also helped with inventory and counting the inventory while I was a sales associate.
Education
Greenon High School
03.2013
Skills
- Claims
- Claims Processing
- Claims Investigation
- Verbal Communication
- Microsoft Office
- Coverage assessments
- Settlement determinations
- Policy Interpretation
- Claims analysis
- Accident Investigations
- Documentation Review
- Estimate Preparation
- Decision-Making
- Critical Thinking
- Customer Service
- Organizing and Prioritizing Work
- Attention to Detail
- Teamwork and Collaboration
- Claims adjustment
- Insurance Coverage Verification
- Documentation abilities
- Documentation skills
- Information Verification
- Eligibility Determination
- Active Listening
- Claim Amount Calculations
- Data Entry
- Coverage Determination
- Denied claims identification
- Appointment Scheduling
- Reporting skills
- Records Management
- Regulatory Compliance Adherence
- Reporting abilities
- Data Entry Software
- Insurance Claim Forms Review
- Skilled in Software
- Documentation processing
- Prior authorization processing
- Document Control
- Proficient in Software
- Excellent administrative abilities
- Policy Review
- Google Suite Proficiency
- Data Integrity
- Paperwork Processing
- Recordkeeping Organization
- Account Management
- Policy analysis
Timeline
Claims Specialist
CodeBlue
01.2019 - 02.2024
Processing specialist
Assurant
01.2016 - 01.2019
Cashier/Customer Service/Sales Associate
Walmart SuperCenter
01.2012 - 01.2016
Greenon High School