Dajah Scoggins
Norfolk,VA
Summary
Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Motivated to maintain customer satisfaction and contribute to company success. Have the ability to properly investigate a situation and resolve problems quickly in accordance with company and regulatory guidelines. Bringing excellent skills in oral and written communication, active listening and analytical problem-solving skills.
Overview
10
10
years of professional experience
Work History
Insurance Billing Premium Payment Specialists
Sentara Health Plan
10.2023 - 01.2024
- Performed various administrative tasks related to processing members payments to their accounts, generating reports, updating records, and maintaining accurate documentation
- Accurately balancing and reconciling health plan accounts receivables
- Collaborated with internal teams to address members billing inquiries and resolved issues promptly
- Managed approximately 50 incoming calls per day from members'
Travel Claims Examiner
Allianz Insurance
10.2021 - 07.2023
- Reviewed claims, identify each incident, and determine coverage in accordance with company contract, conclude what, if any benefit applies and amount to be reimbursed
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout claim examination process.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively
- Document each claim determination and relevant notes into PeopleSoft, in accordance with company guidelines
- Researched discrepancies and escalate questionable claims to Team Leader
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status
Call Center Representative
Aerotek
08.2020 - 03.2021
- Assisted claimants in navigating unemployment benefits system, addressing concerns, and answering inquiries promptly
- Provided information regarding requirements for filing a claim, penalties for fraudulent claims, reemployment services, eligibility status, and appeal procedures
- Assisted clients with completion of applications and with weekly benefit claim for payment of benefit
- Maintained up-to-date knowledge of federal and state regulations governing unemployment insurance programs, ensuring compliance at all times
- Managed approximately 50 incoming calls or more, and emails per day from customers'
Order Service Representative
QVC
06.2019 - 12.2021
- Input order information into system and updated customer accounts to document and track customer orders
- Managed high call volume, while maintaining excellent customer service standards at all times
- Provided accurate product information to customers, while helping them make informed purchasing decisions
- Maintained high level of accuracy while entering orders into computer system, ensuring proper billing and shipping information
- Manged Approximately 60 calls per day from customers'
Claims Processor
Conduent
06.2018 - 06.2019
- Processed new insurance claims or modify existing claims for Medical, Dental, Vision, and Dependent Care for FSA and HRA accounts
- Analyzing insurance information, performing data entry, insurance claims reimbursement, and deciding whether claim should be approved or denied
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality
- Utilized specialized software to process incoming claims, enter data and generate reports
Senior Benefits Specialist
Conduent
09.2017 - 06.2018
- Managed calls concerning benefits questions for all employees pertaining to (Health, Dental, Life Insurance, COBRA)
- Verify benefits and eligibility for employees and dependents
- Handle all employee record with confidentiality under compliance with company, HIPPA, and government regulations
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options
- Presented material at open enrollment regarding insurance changes
- Processed employee life event changes, ensuring timely updates to benefits and coverage for qualifying events such as marriage or birth of a child
- Assisted members with portal navigation, updating account information, password and pin reset
- Utilized multiple software programs including SAM, Word, Excel, and Powerpoint
- Managed approximately 50 incoming calls per day from members'
Food Service Worker
Sentara Norfolk General Hospital
07.2014 - 08.2017
- Maintained safety standards by properly handling food and adhering to sanitation guidelines
- Cleaned and sanitized dishes and utensils, consistently keeping adequate supplies on hand for expected customer loads
- Maintained clean, trash-free workspaces to maximize productivity and safety
- Delivered all meal trays to patient's
- Demonstrated versatility by quickly adapting to various roles within food service environment as needed
Education
High School Diploma -
Bayside High School
Virginia Beach, VA06.2012
Skills
- Time Management
- Active Listening
- Critical Thinking
- Customer Service
- Microsoft Office Proficiency
- Problem-Solving
- Teamwork and Collaboration
- Multitasking
- Adaptability
- Operating systems: CSC, Salesforce, Verint, Cxone, Cisco Finesse, PeopleSoft
Timeline
Insurance Billing Premium Payment Specialists
Sentara Health Plan
10.2023 - 01.2024
Travel Claims Examiner
Allianz Insurance
10.2021 - 07.2023
Call Center Representative
Aerotek
08.2020 - 03.2021
Order Service Representative
QVC
06.2019 - 12.2021
Claims Processor
Conduent
06.2018 - 06.2019
Senior Benefits Specialist
Conduent
09.2017 - 06.2018
Food Service Worker
Sentara Norfolk General Hospital
07.2014 - 08.2017
High School Diploma -
Bayside High School