Summary
Overview
Work History
Education
Skills
Certification
Timeline
background-images

Christy Nixon

Mesquite,TX

Summary

  • Experienced with assessing and evaluating insurance claims with precision and fairness. Utilizes strong analytical skills to ensure accurate and timely resolutions. Track record of effective communication and problem-solving in high-stakes environments.


Overview

17
17
years of professional experience
1
1
Certification

Work History

Desk Adjuster (Auto)

Sedgwick
06.2023 - 09.2024
  • Examined insurance policies and other records and determined insurance coverage
  • Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
  • Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
  • Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
  • Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
  • Developed strong relationships with repair vendors, ensuring quality service and fair pricing for clients in need of repairs after an incident.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Provided valuable insights from audit findings to senior management for strategic decision-making purposes regarding operational improvements or risk mitigation efforts.

Customer Service Advocate

United Healthcare
01.2023 - 06.2023
  • Managed high-volume call center, ensuring prompt and accurate responses to all inquiries related to health benefits.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
  • Contacted care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialist for assistance
  • Assessed medical claims for compliance with regulations and corrected discrepancies.
  • Responded to and resolved on the first call, customer service inquiries and issues by identifying the topic and type of assistance the caller needed such as benefits, eligibility and claims, financial spending accounts and correspondence
  • Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail.
  • Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
  • Helped guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Address gaps in care, reviewing coverage, and referring and enrolling them to internal specialists and programs based on their needs and eligibility
  • Resolved medical claims by approving or denying documentation, calculating benefit due and initiating payment or composing denial letter.

Code Enforcement Officer

Dallas City Hall
11.2016 - 05.2020
  • Enforced compliance with city regulations and ordinances pertaining to land use, zoning, nuisance housing, building codes and health and safety.
  • Facilitated positive relationships with community members by addressing concerns promptly and professionally, fostering trust in the code enforcement process.
  • Leveraged strong negotiation skills to resolve disputes between neighbors regarding shared responsibility for maintaining properties in accordance with local codes.
  • Streamlined the code enforcement process for faster resolutions through diligent record-keeping and timely communication with property owners.
  • Promoted transparency in the code enforcement process by creating and distributing reports on department activities, successes, and areas for improvement.
  • Provided expert testimony in court proceedings related to code enforcement cases, aiding in the successful prosecution of violators.
  • Optimized inspection routes using GIS technology to maximize coverage within assigned areas while minimizing travel time between sites.
  • Served as a liaison between city officials and community members during public meetings, addressing concerns and providing updates on ongoing enforcement efforts.
  • Coordinated efforts with law enforcement agencies when necessary to address criminal activity related to code violations, such as illegal dumping or unlicensed construction work.
  • Supported legal proceedings by providing accurate documentation of violations and actions taken, contributing to successful case outcomes.
  • Patrolled assigned area to identify and evaluate problems.
  • Prepared evidence in support of legal actions taken.
  • Worked with building owners and users to outline actions required to bring structures in compliance with relevant fire code regulations, laws and accepted standards.

Dispatcher

AT&T
03.2012 - 11.2016
  • Answered incoming calls and chats from customers who reported issues with their internet, phone, and/or television services.
  • Accurately recorded details about customers problem, customers information, and location.
  • Contributed to overall call center success by consistently meeting or exceeding key performance indicators, including average handle time, first-call resolution rate, and customer satisfaction scores.
  • Determined the urgency of each service call and assigned technicians accordingly based on priority levels.
  • Contacted available technicians and provided them with necessary information about the customer and their issue.
  • Coordinated appointment times with customers and technicians, considering availability and travel time.
  • Maintained accurate records of work orders, dispatch details, and customer interactions within company systems.
  • Contacted customers to confirm appointment details and checked on the status of repairs.
  • Addressed customer concerns and escalate complex issues to appropriate departments when necessary.

Correctional Officer/911 Operator

Dallas County Sheriff’s Dept.
01.2008 - 03.2012
  • Managed high-risk situations with professionalism and composure, ensuring the safety of all involved parties.
  • Maintained inmate safety through vigilant monitoring of behavior and swift intervention during conflicts.
  • Observed and supervised inmates throughout visits, meal time, recreation, phone calls, and showers.
  • Escorted inmates to and from cells, court, hospitals, and medical appointments.
  • Assisted in the training of new correctional officers, providing guidance on best practices and procedures.
  • Prepared, processed and maintained forms, reports, logs, records, and activity journals.
  • Prevented escapes by diligently inspecting perimeters, doors, windows, gates, fences, and other access points throughout the prison complex regularly.
  • Tracked inmates through head counts, visitor logs, and scheduled activities.
  • Maintained accurate records of inmate incidents or infractions using electronic databases or written logs as required.
  • Improved communication between staff members by participating in daily briefings and sharing critical information about inmate activities.
  • Ensured compliance with all applicable federal, state, and local laws, regulations, and policies governing correctional facilities.
  • Conducted efficient inmate transfers, adhering to strict security protocols while maintaining order and control throughout the process.
  • Maintained calm and professional demeanor while handling high-stress emergency situations, ensuring effective communication with callers.
  • Supported law enforcement efforts by accurately recording and relaying essential details from 911 callers.
  • Continually upgraded knowledge on local geography and landmarks to provide accurate directions to first responders during high-pressure situations.
  • Collaborated with first responders to provide timely updates on ongoing incidents, facilitating informed decision making.
  • Received public emergency and non-emergency calls and supervised response prioritization in order to effectively dispatch official units such as police, fire, and EMS while tracking data in real-time environments.
  • Automated document flow by ensuring logbooks and fire, accident, and emergency reports were maintained with 100% accuracy.
  • Entered and retrieve data from computer systems, such as NCIC, TCIC, and other systems.
  • Facilitated interdepartmental coordination by serving as a liaison between various agencies, ensuring seamless communication flow.

Education

ASSOCIATE’S DEGREE -

University of Phoenix (Axia College)
05.2013

DIPLOMA -

Franklin D. Roosevelt High School
05.2005

Skills

  • Claims analysis
  • Workflow management
  • Customer service
  • Problem-solving
  • Claims investigation
  • Claims processing
  • Policy investigations
  • Complaint handling
  • Decision-making
  • Attention to detail
  • Time management
  • Work order management
  • Multitasking and organization
  • Verbal and written communication
  • Critical thinker
  • Microsoft office

Certification

Department of Insurance Adjuster - All Lines License, 03/01/22

Timeline

Desk Adjuster (Auto)

Sedgwick
06.2023 - 09.2024

Customer Service Advocate

United Healthcare
01.2023 - 06.2023

Code Enforcement Officer

Dallas City Hall
11.2016 - 05.2020

Dispatcher

AT&T
03.2012 - 11.2016

Correctional Officer/911 Operator

Dallas County Sheriff’s Dept.
01.2008 - 03.2012

ASSOCIATE’S DEGREE -

University of Phoenix (Axia College)

DIPLOMA -

Franklin D. Roosevelt High School

Similar Profiles

CREATE PROFILE
Christy Nixon