Summary
Overview
Work History
Education
Skills
Timeline
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Cahrizma Robinson

Jacksonville,FL

Summary

Dedicated claims representative professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results. Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options.

Overview

11
11
years of professional experience

Work History

Claims Specialist

UnitedHealthcare
08.2021 - Current
  • Accurately and confidently handling various types of customer inquiries while engaging and building a consultative relationship in a fast-paced call center environment
  • Confidently processing claims and updating client's beneficiaries and coverage for different organizations and companies
  • Reviewing various forms related to death reports and processing end of life documentation
  • Terminating coverages in the administrative platform, converting records to a claim, calculating fund balances, and placing beneficiary in the claim's examiner
  • Utilizes negotiation skills to settle claims within established authority limits, achieving a 10% increase in claim settlements
  • Upheld fairness and integrity in the determination process by offering opportunities for claimants to provide additional information and context

Claims Processor

Prudential Life Insurance
01.2018 - 07.2021
  • Handled up to 100 customer interactions daily focusing on quality and efficiency achieving a 95% customer satisfaction rate through efficient problem-solving while processing insurance claims accurately and efficiently, adhering to the company's policies and procedures
  • Reviewed and analyzed claim documentation, including receipts, invoices, and policy information while investigating claim discrepancies and resolving issues in collaboration with insurance providers and internal teams
  • Communicated with customers, vendors, and stakeholders to gather necessary information and clarify claim details
  • Maintained detailed records of claim activities, updates, and outcomes using the company's internal systems

Insurance Claims Representative

Florida Blue
08.2014 - 05.2018
  • Responsible for navigating inbound customer care calls in a fast-paced call center environment while responding to requests regarding billing, change of service and technical questions and problem resolution related to company products as well as customer equipment
  • Utilized negotiation skills to settle claims within established authority limits achieving a 10% increase in claim settlements while implementing a knowledge base, resulting in a 20% reduction in common support inquiries
  • Managed provider files submitted by delegated provider entities and/or integrated delivery system while preparing accurate information in a timely way to the provider
  • Performs internal audit of provider record, ensuring accuracy against rosters while coordinating the process for pricing arrangements involving high profile groups and hospital systems joining the network

Education

Associate of Arts - Human Services

Florida State College At Jacksonville
Jacksonville
05-2024

High School Diploma -

First Coast High School
Jacksonville
06-2014

Skills

  • Medical Billing
  • Claims Processing
  • Inbound & Outbound Calls
  • Issue & Complaint Resolution
  • Data Entry
  • All Microsoft Office
  • Empathy
  • Claims Adjusting
  • Zendesk
  • Tech Support
  • CRM
  • Salesforce
  • Fraud Detection
  • 60 WPM

Timeline

Claims Specialist

UnitedHealthcare
08.2021 - Current

Claims Processor

Prudential Life Insurance
01.2018 - 07.2021

Insurance Claims Representative

Florida Blue
08.2014 - 05.2018

Associate of Arts - Human Services

Florida State College At Jacksonville

High School Diploma -

First Coast High School

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Cahrizma Robinson