Carissa Dew
STATE_US
Summary
Diligent Claims Representative with solid background in processing and managing claims efficiently. Adept at assessing coverage and liability, and resolving complex claims issues. Proven ability to utilize strong analytical and communication skills to deliver exceptional service.
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
8
8
years of professional experience
Work History
Claims Representative
State Farm
01.2024 - Current
- Delivered thorough claims assessments by analyzing documentation and communicating effectively with policyholders throughout the process.
- Coordinated with cross-functional teams to resolve complex claims issues, enhancing customer satisfaction and trust.
- Evaluated claim submissions for accuracy, identifying discrepancies and recommending necessary adjustments in a timely manner.
- Developed comprehensive reports detailing claim trends and outcomes, informing strategic decision-making across departments.
APPLE EXPERT
ENJOY TECHNOLOGY(ASURION)
09.2021 - 01.2024
- Conducted detailed assessments of customer devices, identifying technical issues and recommending solutions.
- Provided hands-on training to customers on device features and optimal usage practices.
- Collaborated with technical support teams to troubleshoot complex service requests effectively.
- Documented customer interactions and resolutions in the internal support system for future reference.
- Maintained up-to-date knowledge of product offerings and industry trends to enhance customer engagement.
- Facilitated follow-up communications with customers to ensure satisfaction after service delivery.
- Maximized sales potential by identifying cross-selling opportunities and offering tailored recommendations based on individual client needs.
CALL CENTER REP
SOUTHEASTRANS
05.2018 - 08.2021
- Assist members efficiently and in a timely manner by projecting a polite, courteous, and professional attitude always.
- Assist members with all transportation concerns.
- Maintain accurately entered data.
- Adhere to HIPAA guidelines regarding member confidentiality.
- Maintain an acceptable attendance and tardiness record.
- Schedule standing orders and demand trips using the NET InSight transportation management system.
- Schedule subscription trips to providers according to the Provider Assignment roster
- Maintain professionalism when dealing with medical facilities.
- Provide clinical staff, member providers, and members with the necessary paperwork to maintain clear communication.
- Insurance verification for both dialysis and nursing home patients.
- Retrieve messages from the call center for daily appointments.
- Train new employees.
- Assist dispatchers in writing up send-backs.
- Check member files for accuracy in the system.
- Process monthly recertification and attendance verification reports.
Education
Bachelor's - Criminal Justice
Strayer University
04.2024
High School Diploma - undefined
Newton High School
01.2014
Skills
- Customer Service
- Integrity
- Management
- Sales
- Scheduling
- Leadership
- Computer Literacy
- Microsoft Office
- Military Experience
- Call Center
- Transportation/Delivery
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Team collaboration
- Data analysis
- Decision-making
- Settlement negotiation
- Flexible schedule
- Insurance regulations
- Claims processing
- Attention to detail
- Active listening
- Critical thinking
- Teamwork and collaboration
Timeline
Claims Representative
State Farm
01.2024 - Current
APPLE EXPERT
ENJOY TECHNOLOGY(ASURION)
09.2021 - 01.2024
CALL CENTER REP
SOUTHEASTRANS
05.2018 - 08.2021
High School Diploma - undefined
Newton High School
Bachelor's - Criminal Justice
Strayer University