Carolyn Crandall
Webberville,MI
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Organized professional with a background in office administration. Known for high productivity levels and the ability to efficiently complete tasks, ensuring smooth operations. Skilled in data entry, file management, and scheduling, with strong capabilities in multitasking and prioritizing workloads. Excel through communication, problem-solving, and adaptability, contributing to team success and operational excellence.
Overview
29
29
years of professional experience
Work History
Medical Only Representative
CCMSI
Okemos , Michigan
06.2024 - Current
- Processed all new medical only claims.
- Evaluating coverage and determining compensability.
- Completing and preparing documentation for referrals, managing initial contacts with clients, claimants and medical providers.
- Analyzed medical claims for accuracy, completeness, and compliance with company policies and procedures.
- Documented all decisions made on claims in accordance with established guidelines.
- Utilized various software and tools to streamline processes and optimize performance.
Claim Clerk
CCMSI
Okemos , Michigan
06.2023 - 06.2024
- Wage loss calculations, state forms, Assigning new claims, Recovery checks processing, Incoming and outbound mail, Provider statement, provider calls for medical request, nurse case manager logs and invoices, carrier audits.
- Provided excellent customer service by responding to inquiries promptly and professionally.
- Maintained accurate records of all claims activities in accordance with company policies.
- Utilized office software applications to create presentations, spreadsheets, and documents as required.
- Greeted visitors in a professional manner and provided assistance when necessary.
- Maintained an organized filing system of paper documents and electronic files.
- Organized office operations and procedures, such as managing calendars, scheduling appointments, preparing reports and maintaining records.
- Provided administrative support to multiple departments as needed.
- Performed data entry tasks into various computer systems accurately and efficiently.
- Monitored office expenses and submitted purchase requests.
- Utilized office equipment such as printers, copiers, and fax machines efficiently.
- Maintained confidentiality of sensitive information and documents.
- Ordered office supplies and managed inventory to ensure a well-stocked office.
- Organized files, developed spreadsheets, faxed reports and scanned documents to improve organizational workflow.
- Handled incoming and outgoing mail and packages, including preparation for shipping.
- Answered and directed phone calls to appropriate staff members.
Claims Assistant - Workers Compensation
Sedgwick
Howell, MI
06.2021 - 04.2023
- Receive inbound and outbound calls to providers, claimants and clients.
- Processing payments from medical bills, mileage reimbursement, legal, investigation and settlements.
- Provided documents for authorizations or refusals for our files and regulatory purposes.
- Completed state work compensation forms for Michigan.
- Reviewing claim documentation and file handling.
- Completed Claims intake forms for clients.
- Covered adjusters desk while out of office.
- Completed quarterly claim audit documentation for review.
- Worked in Juris, and claims connect claims.
- Used Excel and Adobe daily for Claims management.
- Completed Claims Progression Program-11/19/21
Customer Service Center
Hanover Insurance
Howell, MI
01.2020 - 06.2021
- Company Overview: Citizens/Hanover Group
- Receive inbound calls to assist agents and policyholders with questions regarding their insurance needs.
- Educate and offer advice on insurance policies and help make any changes needed and continue to follow up as needed.
- Provide insurance quotes to policyholders and agents.
Specialist Customer Support 2
Sedgwick
Howell, MI
04.2019 - 01.2020
- Company Overview: Formally York
- Respond to incoming calls.
- Provide immediate responses to telephone inquiries and link callers to Howell and Sedgwick services.
- Conduct data entry of collected information for reports of injuries.
- Process and pay provider bills and attorney bills.
Specialist Customer Support 1
Sedgwick
Howell, MI
02.2019 - 04.2019
- Company Overview: Formally York
- General mail duties.
- Prep mail for imaging/ scanning and indexing.
- Escalated indexing.
- Formally York
Dry Selector
Aldi Warehouse
Webberville, MI
04.2014 - 02.2019
- Store fulfillment for products needed.
- Worked directly with many groups of people to get tasks done.
- Pick by voice system.
Customer Order Specialist
Home Depot
Howell, MI
03.2001 - 04.2014
- Answered customers questions and addressed problems and complaints in person and via phone.
- Oversaw all installed sales from getting special order materials in on a timely manner with vendors and coordinating install dates with providers.
- Educated customers on product and service offerings.
- Offered exceptional customer service.
- Collaborated with customer service team members to give exceptional service throughout the entire shopping and purchasing experience.
Assistant Manager
Traditional Treasures
Williamson, MI
08.1996 - 10.2000
- Maintained visually appealing and effective displays for the entire store.
- Oversaw all daily operations of store.
- Processed shipments and maintained organized stock shelves.
- Unloaded trucks, stocked shelves and carried merchandise out on the floor for customers.
- Employee scheduling.
- Cash handling accuracy.
- Inventory control procedures.
- Expedite special orders.
- Proficient in MS Office
- Down stock products.
- Inventory team pulled products for install and coordinated deliveries.
Education
Lansing Community College
01.1998
High School Diploma -
Williamston Schools
Williamston, MI01.1996
Skills
- Cash handling accuracy
- Inventory control procedures
- Proficient in Microsoft Excel, Word and Adobe
- Data entry
- Customer service
- Office organization
- Record keeping
- Time management
- Problem solving
- Attention to detail
- Team collaboration
- Medical claims processing
- Claims documentation
Additional Information
T-ball Commissioner for Webberville rec sports for two years. Member of the employee team at the Home Depot and CCMSI, Participates in the employee committee on planning fundraisers, and holiday parties.
Timeline
Medical Only Representative
CCMSI
06.2024 - Current
Claim Clerk
CCMSI
06.2023 - 06.2024
Claims Assistant - Workers Compensation
Sedgwick
06.2021 - 04.2023
Customer Service Center
Hanover Insurance
01.2020 - 06.2021
Specialist Customer Support 2
Sedgwick
04.2019 - 01.2020
Specialist Customer Support 1
Sedgwick
02.2019 - 04.2019
Dry Selector
Aldi Warehouse
04.2014 - 02.2019
Customer Order Specialist
Home Depot
03.2001 - 04.2014
Assistant Manager
Traditional Treasures
08.1996 - 10.2000
Lansing Community College
High School Diploma -
Williamston Schools