Brianna Spencer
Niagara Falls
Summary
Results-driven professional with a solid background in insurance claims processing and customer service. Known for effectively resolving discrepancies and delivering exceptional customer assistance, contributing to enhanced satisfaction and loyalty.
Dependable retail sales professional with experience in dynamic, high-performance environments. Skilled in processing transactions, handling cash, using registers and arranging merchandise. Maintains high-level customer satisfaction by smoothly resolving customer requests, needs, and problems.
Overview
15
15
years of professional experience
Work History
Claims Adjuster
Highmark Blue Cross Blue Shield
09.2023 - Current
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Identified and resolved discrepancies between patient information and claims data.
Customer Service Representative
Thermo Fisher
06.2021 - 09.2023
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Documented and detailed calls and complaints using call center's CRM database.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Detailed payment options and explained price, receipt and billing details to customers.
- Delivered prompt service to prioritize customer needs.
- Maintained up-to-date knowledge of product and service changes.
Auto Claims Adjuster
National General Insurance
03.2019 - 04.2021
- Prepared files, letters and notices.
- Logged, allocated and managed claims.
- Followed up with customers on unresolved issues.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Developed in-depth understanding of insurance policies and procedures.
- Examined photographs and surveillance and any other documents relating to claims.
- Negotiated with claimants to settle claims.
- Issued payouts to claimants.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
Sales Associate
Tommy Hilfiger
10.2011 - 10.2020
- Answered customer questions about sizing, accessories, and merchandise care.
- Engaged with customers to build rapport and loyalty.
- Helped customers locate products and checked store system for merchandise at other sites.
- Provided positive first impressions to welcome existing, new, and potential customers.
- Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
- Performed cash, card, and check transactions to complete customer purchases.
- Provided exceptional services and pleasant shopping experiences to retail customers.
Education
Bachelor of Science - Education
SUNY Buffalo State
Buffalo, NYSkills
- Policy investigations
- Automobile claims specialist
- Property adjusting
- Insurance fraud expertise
- Customer assistance
- Shelf stocking
- Professional appearance
- Cash register operation
- Continuous learning mindset
- Conflict resolution techniques
- Claims analysis expertise
- Insurance claims processing
Timeline
Claims Adjuster
Highmark Blue Cross Blue Shield
09.2023 - Current
Customer Service Representative
Thermo Fisher
06.2021 - 09.2023
Auto Claims Adjuster
National General Insurance
03.2019 - 04.2021
Sales Associate
Tommy Hilfiger
10.2011 - 10.2020
Bachelor of Science - Education
SUNY Buffalo State