Diamond Perkins
Cordova,TN
Summary
Dedicated and detail-oriented Claims Specialist with 5 years of experience in processing claims across various lines of business. Skilled in reviewing and verifying claims, ensuring compliance with industry standards, and collaborating with internal teams for seamless resolution. Adept at managing claims using specialized software and providing exceptional service to policyholders. Proven track record as a Remote Claims Processor and Claims Associate, consistently delivering accuracy, efficiency, and professionalism in a remote setting.
Overview
8
8
years of professional experience
Work History
Claims Processor (Remote)
Internal Revenue service
04.2021 - 09.2024
- I maintained compliance with company policies and regulatory requirements, while ensuring quality, accuracy, and turnaround on processing high-volume claims daily
- Reviewed claims for accuracy and proper documentation needed for underwriting and final approval
- Worked with adjusters, underwriters, and customer service reps to address discrepancies and expedite claims
- Tracked each claim, using claims management software, and prepared comprehensive reports for the management
- Continuously followed up with clients to provide claim status updates and assistance when needed
Claims Specialist
Sedgwick
01.2018 - 02.2021
- Processed more advanced-level claims from beginning up to and including closure, verifying documentation; working with involved parties, and closing the process on time
- Collaborated with internal parties in terms of Indeed solutions
- Above all, sought to avoid delayed resolution of claims escalations by providing them worked out
- Implemented standards and procedures, supervised the preparation of available documentation, also recruited and assured adherence to guidelines
- Identified and referred suspicious or possible fraudulent claims to the fraud investigation unit for further handling
Claims Associate
Bank of bartlett
Memphis, TN
09.2016 - 11.2017
- Functioned as a liaison to the claims team through managing a book of claims, review of initial claim submissions, and providing them METLIFE trusted documents
- I assisted in the final review and approval of claims to ensure overall compliance with all regulatory and policy requirements
- I recorded all claim activities while maintaining detailed documentation for auditing and reporting functions
- Handled inquiries from policyholders and accurately conveyed information on claims status, where required
- Resolved simple issues
- Worked with senior claims processor to escalate challenging claims and ensure timely resolution
Education
High school diploma - STUDY
Southeast Prep Academy
Memphis, TN05.2011
Skills
- Data Entry
- Payments posting
- Claims Management Software
- Time Management
- Coverage assessments
- Microsoft Office
- Policy Interpretation
- Settlement determinations
- Team Collaboration
- Documentation & Data Accuracy
- Claims Processing
- Allocating claims
- Transactions reconciliation
- Claims review
- Problem-Solving
- Regulatory Compliance
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Claims Processor (Remote)
Internal Revenue service
04.2021 - 09.2024
Claims Specialist
Sedgwick
01.2018 - 02.2021
Claims Associate
Bank of bartlett
09.2016 - 11.2017
High school diploma - STUDY
Southeast Prep Academy