Summary
Overview
Work History
Education
Skills
Certification
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Timeline
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Darnisha Lester

Altamonte Springs,FL

Summary

Dynamic professional with a proven track record at CVS Health, adept in CRM software and showcasing exceptional verbal communication skills. Excelled in enhancing customer satisfaction through effective case management and process improvement, including a significant role in resolving escalated customer concerns. Demonstrates a strong commitment to service excellence and operational efficiency.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Case Management Coordinator

CVS Health
06.2022 - Current
  • Perform supervisor duties when taking over escalated phone calls.
  • Review and process incoming phone calls, emails, and letters from customers.
  • Review and process claims, payments, and Rx refill requests.
  • Partner with management to resolve customer concerns in a timely manner.
  • Provide medication overrides for members.
  • Temporarily update the member's insurance eligibility.
  • Serve as a customer advocate when researching, responding, or interpreting company procedures, or policies.

CLAIMS ADJUSTER

America's Insurance
08.2021 - 01.2022
  • Licensed Florida claim adjuster (Property & Casualty) (12hr/day)
  • Processed 14.2 K ALE/Loss of Use claims for those affected by Hurricane Ida
  • Recouped 3.6M in reimbursement expenses to Hurricane victims
  • Xactimate Proficiency
  • Communicated regularly with claimants via phone calls, emails or letters regarding status updates or additional documentation requests
  • Used strong customer service skills to negotiate with policyholders to settle claims

FLIGHT ATTENDANT

Silver Airways
Orlando, US
01.2020 - 06.2021
  • Greet passengers as they board the plane and complete a count and compliance check
  • Review over safety rules and regulations daily as the plane takes off and land
  • Service passengers in-flight
  • Perform security search and restock supplies needed in the plane

PHARMACY TECHNICIAN

Walgreens
Orlando, US
05.2019 - 01.2020
  • Process new patient registration by entering data into the appropriate system
  • Handles correspondence to patients (inbound calls, chats, emails)
  • Handles patient prescription request with HIPAA guidelines
  • Enter refill orders for processing
  • Troubleshoot to obtain missing prescription information

REMOTE CLAIM EXAMINER ASSISTANT

Olympus Insurance
TECH, FL
05.2018 - 05.2019
  • Assist and examined catastrophe claims for Olympus Insurance
  • Assist and handled fast track claims via phone
  • Assist and examined claims that were adjusted by a field adjuster

FLOOD EXAMINER

Work Specialty Group
Winter Park, US
04.2017 - 05.2018
  • Examined photographs and statements
  • Analyzed data to identify underlying principles
  • Interviewed claimants and witnesses to gather factual information
  • Evaluated company operations against established standards and regulatory requirements
  • Maintained accurate records of audit findings and identified areas for improvement in internal processes

Education

ASSOCIATE'S DEGREE - INTERIOR ARCHITECTURE AND DESIGN

Academy of Art University
01.2025

HIGH SCHOOL DIPLOMA -

Penn Foster College Online
01.2012

Skills

  • Strong Verbal Communication
  • Microsoft Office Suite
  • Smartsheet
  • Pharmacy technician experience
  • Order entry
  • CRM software
  • Oracle
  • Account management
  • Process improvement
  • Microsoft Outlook
  • Microsoft Project
  • HIPAA
  • Customer service
  • Cash register
  • Typing
  • Salesforce
  • Certified Wedding Planner
  • Supervisor experience
  • PC Proficiency

Certification

  • CPR Certification
  • AED Certification
  • Resident Insurance License; 0620 - Adjuster - All Lines

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Timeline

Case Management Coordinator

CVS Health
06.2022 - Current

CLAIMS ADJUSTER

America's Insurance
08.2021 - 01.2022

FLIGHT ATTENDANT

Silver Airways
01.2020 - 06.2021

PHARMACY TECHNICIAN

Walgreens
05.2019 - 01.2020

REMOTE CLAIM EXAMINER ASSISTANT

Olympus Insurance
05.2018 - 05.2019

FLOOD EXAMINER

Work Specialty Group
04.2017 - 05.2018

ASSOCIATE'S DEGREE - INTERIOR ARCHITECTURE AND DESIGN

Academy of Art University

HIGH SCHOOL DIPLOMA -

Penn Foster College Online

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