China Reynolds
Roseville,MI
Summary
Proven track record in claims processing and customer service, Excelled in accuracy, regulatory compliance, and professionalism, enhancing customer loyalty and operational efficiency. Demonstrated expertise in claims review and critical evaluation, achieving top performance metrics and ensuring meticulous attention to detail in high-stress environments.
Overview
6
6
years of professional experience
Work History
Claims Processor
Alorica
Remote
01.2020 - 06.2024
- Examined and investigated claims.
- Assessed the validity of claims for approval.
- Handled claims through a web-based application.
- Completed tasks by verifying data from multiple source documents and incorporating additional information.
- Followed up on pending documents requiring analysis.
Claims Adjuster
Dialog Direct
Remote
10.2019 - 12.2020
- Investigated and evaluated insurance claims to determine the extent of the company’s liability.
- Review and verify claim Information, including medical and accident reports.
- Collaborated with other team members and departments to resolve complex claims.
- Provided excellent customer service to claimants and policy holders.
Customer Service Representative
Robert Half
Remote
02.2018 - 07.2019
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Enhanced customer loyalty by offering personalized solutions tailored to individual needs.
Education
Diploma - Medical Terminology
Dorsey College
Roseville, MI12.2020
High School Diploma - English
Denby High School
Detroit, MI06.2018
Skills
- FSA and HSA claims
- Claims review
- Accuracy and Precision
- Claims Processing Software
- Regulatory Compliance
- Professionalism and Ethics
- Data entry proficiency
- Medical terminology knowledge
- Attention to Detail
- Critical Evaluation
- Data Entry
- Claims Processing
- Claims adjustment
- Insurance Coverage Verification
- Microsoft Office
- Customer Service
Timeline
Claims Processor
Alorica
01.2020 - 06.2024
Claims Adjuster
Dialog Direct
10.2019 - 12.2020
Customer Service Representative
Robert Half
02.2018 - 07.2019
Diploma - Medical Terminology
Dorsey College
High School Diploma - English
Denby High School