Cloressa Gracie
Cranberry Township,PA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
24
24
years of professional experience
Work History
Owner/Operator
Jordan's Donuts
10.2017 - Current
- Increased customer satisfaction by providing high-quality services and timely communication.
- Managed daily operations for optimal efficiency, streamlining processes to reduce costs.
- Developed and implemented successful marketing strategies, resulting in increased brand awareness and customer base.
- Established strong relationships with suppliers, ensuring consistent delivery of goods and services at competitive prices.
- Overseeing inventory management, reducing waste and maintaining adequate stock levels to meet demand.
Claims Representative
Penn National Insurance
12.1999 - 04.2016
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Collaborated with cross-functional teams to expedite complex claims investigations and resolutions.
- Minimized financial losses by identifying fraudulent claims through thorough analysis and investigation.
- Negotiated favorable settlements with claimants, resulting in cost savings for the company.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Developed strong relationships with clients, facilitating trust and open communication during the claims process.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Trained new Claims Representatives on company policies, procedures, and software systems, improving overall team productivity.
- Facilitated prompt payment of approved claims by liaising with finance department to ensure smooth transaction processing.
- Conducted thorough research on industry trends, enabling proactive adjustments to internal processes as needed for improved performance.
- Demonstrated expertise in interpreting policy language accurately, leading to better-informed decisions on coverage application during claims evaluation.
- Served as a subject matter expert on specialized claims, providing guidance and support to other team members when needed.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Updated claims system to track claim status and provide relevant information to other department.
- Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
- Followed up with customers on unresolved issues.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.
- Interviewed policyholders to verify information and obtain additional details.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Investigated accidents or incidents to determine cause and extent of damages.
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Education
High School Diploma -
Clarion University of Pennsylvania
Clarion, PAHigh School Diploma -
Butler Area High School
Butler, PA 06.1993
Skills
- Operations Management
- Personnel Management
- Operations Oversight
- Hiring
- Payroll Processing
- Strategic Planning
- Staffing
- Marketing Strategy Development
- Inventory Control
- Team Leadership
- Adaptability and Flexibility
- Staff Training and Development
- Time Management
- Attention to Detail
- Quality Assurance
- Customer Service
- Conflict Resolution
- Decision Making
- Organizational Skills
- Sales Strategy
- Problem Solving
- Dependable and Reliable
- Customer-Oriented
- Inventory Management
- Customer Retention
Timeline
Owner/Operator
Jordan's Donuts
10.2017 - Current
Claims Representative
Penn National Insurance
12.1999 - 04.2016
High School Diploma -
Clarion University of Pennsylvania
High School Diploma -
Butler Area High School