Briunna Hornsby

* Investigated insurance claims by reviewing documentation, gathering evidence, and interviewing claimants.

* Verified policy coverage, limits, and eligibility for property damage and liability claims.

* Evaluated repair estimates, medical costs, and claim documentation to determine settlement values.

* Detected potential fraud by analyzing inconsistencies and requesting supporting documentation.

* Negotiated claim settlements with customers, contractors, and legal representatives.

* Maintained detailed claim files and accurate documentation while meeting company compliance standards.

* Assisted patients with specialty medication orders through inbound and outbound calls.

* Verified insurance eligibility, benefits, and prior authorizations.

* Processed new prescriptions and refill requests while ensuring accurate documentation.

* Coordinated medication shipments and resolved insurance-related issues.

* Educated patients on CVS Specialty services and enrollment processes.

* Escalated clinical concerns to pharmacists.

* Delivered compassionate, high-quality customer support in a remote environment.

* Assisted customers by phone and email with billing, account management, and service requests.

* Set up new utility services, transfers, and account changes.

* Handled escalated customer concerns with professionalism and empathy.

* Processed disconnections, reconnections, and payment arrangements for delinquent accounts.

* Responded to customer inquiries and resolved billing issues efficiently.

* Trained new employees on customer service procedures and company policies.

* Utilized CRM systems and multiple software applications to manage customer accounts.