Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

December Latimore

Shellman,GA

Summary

Detail-oriented Claim Specialist driven to resolve claims fairly while representing interests of employer. Conducts thorough and informed investigations, precisely evaluates losses and negotiates settlements that satisfy diverse parties. Builds and maintains professional and productive relationships and works to understand potentially conflicting points of view.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Claim Benefit Specialist

Cigna
Bloomfield, CT
01.2022 - 10.2023
  • Provided excellent customer service throughout the entire claims process.
  • Advised claimants on available benefits under their policy coverage.
  • Assessed damages sustained by insureds due to property loss or personal injury.
  • Analyzed medical reports, bills, legal documents, or other information related to claims.
  • Developed effective relationships with customers through communication via phone or email.
  • Maintained timely and accurate records of all claim activity.
  • Ensured that all documentation was accurately entered into the system.
  • Responded to inquiries from claimants, attorneys, medical providers. regarding the status of their claim.
  • Reviewed policies and procedures regularly to ensure they are up-to-date with industry standards.

Claims Representative

BroadPath Healthcare
Tucson, AZ
06.2019 - 12.2021
  • Processed a high volume of claims efficiently while maintaining quality standards.
  • Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
  • Handled customer inquiries regarding insurance policy coverage details and payment status updates.
  • Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
  • Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
  • Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
  • Verified details with policyholders and requested additional information.

Technical Support Representative

Kelly Connect
Blue Ash, OH
10.2016 - 01.2019
  • Troubleshot customer inquiries related to software and hardware issues.
  • Assisted customers with various types of technical issues via email, live chat and telephone.
  • Resolved escalated customer service issues in a timely manner.
  • Assisted customer in understanding products, components and systems using technical demonstration.
  • Assisted customers with installation of new hardware and software applications.
  • Developed and maintained strong relations with customers to meet quality expectations.

Education

High School Diploma -

Randolph Clay High School
Cuthbert, GA
05-2015

High School Diploma -

Middle Georgia College
Cochran, GA

Skills

  • Claims Processing
  • Insurance Knowledge
  • Policy Interpretation
  • Documentation Review
  • Compliance Management
  • Verbal Communication
  • Microsoft Office
  • Claims Investigation
  • Insurance Claim Forms Review
  • Customer Service
  • Data Entry
  • Information Verification
  • Data Transcription
  • Active Listening
  • Insurance Coverage Verification

Certification

  • Hippa Certification # 1100333
  • Pharmacy Technician Lincense # PHTC075302

Timeline

Claim Benefit Specialist

Cigna
01.2022 - 10.2023

Claims Representative

BroadPath Healthcare
06.2019 - 12.2021

Technical Support Representative

Kelly Connect
10.2016 - 01.2019

High School Diploma -

Randolph Clay High School

High School Diploma -

Middle Georgia College

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December Latimore