Clauny Toussaint
Tampa,FL
Summary
Dedicated customer service professional with a proven track record of success in telephone and face-to-face interactions. Experienced in troubleshooting, providing tech support, and delivering exceptional customer care. Proficient in utilizing major customer service software, adept at handling customer complaints, and committed to maintaining a positive and friendly demeanor. Eager to leverage extensive experience in a customer service role and authorized to work in the US for any employer.
Overview
7
7
years of professional experience
Work History
Remote Customer Service Claims
The Hartford
Fort Lauderdale
09.2024 - 06.2025
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Worked flexible hours across night, weekend, and holiday shifts.
- Efficiently adjusted to innovative software and technology solutions.
- Strengthened communication skills through regular interactions with others.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Organized and detail-oriented with a strong work ethic.
- Paid attention to detail while completing assignments.
- Managed time efficiently in order to complete all tasks within deadlines.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Proven ability to learn quickly and adapt to new situations.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Proved successful working within tight deadlines and a fast-paced environment.
Remote Banking Acquisitions Speaking
USAA Federal Savings Bank
Tampa, FL
09.2023 - 08.2024
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Paid attention to detail while completing assignments.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Strengthened communication skills through regular interactions with others.
- Adaptable and proficient in learning new concepts quickly and efficiently.
Remote Claims Specialist
AmeriHealth Caritas
Jacksonville,FL
04.2021 - 08.2023
- Adhered to HIPAA regulations consistently.
- Facilitated timely filing through submission of electronic and paper claims documentation.
- Handled substantial number of medical claims each day.
- Applied claims processing standards to determine payment or rejection of medical claims.
- Handled communications with insurance companies.
Remote Insurance Verification Coordinator-Remote
Quest Diagnostics
Tampa, FL
01.2018 - 03.2021
- Processed patient intakes, including case histories and insurance details.
- Handled OASIS documentation for patient visits efficiently.
- Tracked status of prior authorization requests with diligence.
- Evaluated copay calculations in accordance with current insurance policies.
Education
High School Diploma -
American Academy Of Pinecrest
Miami, FLSkills
- Thorough Claims Reviews
- Benefits Guidelines
- Customer Service
- Data Analysis
- Telephone Etiquette
- Determine Medical Necessity
- Health Insurance Industry Knowledge
- Complex Problem-Solving
- Insurance Claims
- Account Reconciliation
- Provider Relations
- Electronic Claims Processing
- HIPAA Procedures
- Fee Billing
- Active Learning
- Insurance Plan Verification
- Meticulous Recordkeeping
- Liability Determinations
- Customer Experience
- Policy Modification
- Settlement Verification
- Customer Inquiries
- Payment and Investigation Escalations
- Account Information Review
- Work Organizing and Prioritizing
References
Available Upon Request
Languages
French
Native or Bilingual
Timeline
Remote Customer Service Claims
The Hartford
09.2024 - 06.2025
Remote Banking Acquisitions Speaking
USAA Federal Savings Bank
09.2023 - 08.2024
Remote Claims Specialist
AmeriHealth Caritas
04.2021 - 08.2023
Remote Insurance Verification Coordinator-Remote
Quest Diagnostics
01.2018 - 03.2021
High School Diploma -
American Academy Of Pinecrest