DEANNA Young
Grand Prairie ,TX
Summary
Experienced claims professional well-versed in claim management and resolution, known for strategic approach to resolving disputes and ensuring compliance with industry standards. Reliable team collaborator focused on achieving optimal outcomes and adapting to changing requirements. Skilled in negotiation and critical thinking, with a track record of accurately and efficiently analyzing and processing diverse claims. Strong investigative skills and attention to detail ensure fair settlements while maintaining compliance with industry regulations and providing excellent customer service. Proficient in analytical problem-solving and effective communication. Proven record in handling and resolving complex claims efficiently, adept at analyzing data, identifying discrepancies, and providing solutions that drive positive outcomes. Effective team collaborator, prioritizing achieving results and adapting to evolving requirements. Skills in negotiation, customer service, and regulatory compliance consistently ensure accuracy and fairness in all aspects of work.
Overview
10
10
years of professional experience
Work History
Claims Specialist
State Farm
07.2022 - Current
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Identified fraudulent claims through diligent investigation and collaboration with law enforcement agencies when necessary.
- Improved claim processing efficiency by streamlining workflows and implementing time-saving strategies.
Member Engagement Coordinator
Signify Health
04.2021 - 07.2022
- Identified members' needs and matched to product or service in best interest.
- Managed member relationships by resolving problems.
- Handled phone calls related to members' accounts or general questions about products and services.
- Used multiple information systems to analyze interactions and deliver detailed results.
- Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Verified client information by analyzing existing evidence on file.
- Checked documentation for accuracy and validity on updated systems.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
- Scheduled appointments with applicants to gather information and explain benefits processes.
Collection Specialist
NCS
03.2019 - 03.2021
- This agency reports directly to the Department of Education principal responsibility was to recover student loans through settlement, payment plans, and prevent re-default
- Negotiate immediate full payments or acceptable and timely payment arrangements
- Collect customer payments in accordance with payment due dates
- Followed State and FDCPA Guidelines to supervise and train staff
- Assisted Borrowers over the phone via 3rd party, to resolve and negotiate repayments
- Handled anywhere between 150 - 250 calls daily
- Used Skip Tracing Techniques
- Identify and discuss issues attributing to account delinquency with management
- Provide timely follow-up on payment arrangements
- Review and maintain all customer information for assigned accounts
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Used scripted conversation prompts to convey current account information and obtain payments.
- Used skip tracing and other techniques to locate debtors.
- Listened to customers and negotiated solutions that met creditor and debtor needs.
Healthcare Customer Service Representative
Teladoc Inc
03.2016 - 04.2017
- Received inbound phone calls
- Scheduled patient consultations with doctors
- Secured patient medical history according to HIPAA
- Verified patient insurance
- Completed registration by fully verifying customer's information Resolved any issues that may occur during the call
Leasing Customer Service and Collection Representative
GM Financial
02.2015 - 02.2016
Education
Bachelor of Science - Psychology
SNHU
2017
Skills
- Microsoft Office Suite Expert
- Excellent Communication Skills
- Strong Problem Solving Aptitude
- Team Leadership
- Avaya Software
- Latitude
- Dial Connect
- Exceptional Workflow
- Management
- Credit and collections
- Training and Development
- Planning and Coordination
- Teamwork and Collaboration
- Personal, casualty and property loss
- Policy investigations
- Underwriting knowledge
- Applicant engagement
- Effective communication skills
- Data Entry
- Claims processing
- Claims
- Claims investigation
- Settlement determinations
- Policy interpretation
- Claims analysis
- Documentation review
- Estimate preparation
- Claims trend analysis
- Complex claims consulting
- Decision-making
- Attention to detail
- Insurance coverage verification
- Claims adjustment
- Claim amount calculations
- Coverage determination
- Insurance claim forms review
Timeline
Claims Specialist
State Farm
07.2022 - Current
Member Engagement Coordinator
Signify Health
04.2021 - 07.2022
Collection Specialist
NCS
03.2019 - 03.2021
Healthcare Customer Service Representative
Teladoc Inc
03.2016 - 04.2017
Leasing Customer Service and Collection Representative
GM Financial
02.2015 - 02.2016
Bachelor of Science - Psychology
SNHU
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