Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

DJAVAN GRANT

MESQUITE,TEXAS

Summary

Experienced Eligibility Specialist and Claim Handler with 7+ years of expertise in project management, claim negotiation, and benefit specialist roles. Proven track record of providing exceptional customer service, attention to detail, and successful claim resolution. Seeking opportunities to further develop customer service skills and progress toward a rewarding career, ultimately aiming to become a healthcare policy analyst.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Total Loss Claims Adjuster

Liberty Mutual Insurance Company
Remote
01.2023 - Current
  • Investigated claims to assess liability determinations
  • Analyzed and audited open claims to calculate additional payments owed.
  • Negotiated settlements with claimants, attorneys, and other parties involved in the claim process.
  • Managed total loss handling process for Liberty Mutual Insurance Company.
  • Reviewed policy coverage to ensure compliance with state regulations and company procedures.

Project Manager

Grow Ur Potential
Mesquite, Texas
01.2023 - Current
  • Oversaw projects and collaborated with team members to manage new projects at Grow Ur Potential
  • Utilized project management software for tracking, and monitoring progress, deadlines, and budget allocation
  • Oversaw quarterly finance projects, adding my touch to the financial game plan
  • Managed multiple projects with competing deadlines simultaneously.
  • Provided guidance to team members regarding tasks assigned to them.

Total Loss Specialist

State Farm Mutual Automobile Insurance
Remote
01.2019 - 01.2023
  • Analyzed vehicle history reports to determine if a total loss was warranted.
  • Negotiated settlements with repair shops and claimants.
  • Investigated, documented and processed total loss claims for automobile and property damage.
  • Communicated effectively with clients via telephone, email, or written correspondence.
  • Conducted thorough investigations of all reported losses, including interviewing witnesses, obtaining photographs, and gathering evidence as needed.
  • Resolved disputes between parties involved in total loss claims.

Asset Protection Partner

Target Company
01.2017 - 01.2018
  • Uncovered potential theft or fraud on the store premises through thorough identification and investigation
  • Actively monitored and assessed store operations, staying ahead of potential challenges and maintaining a vigilant stance.
  • Negotiated contracts between partners or vendors in order to obtain favorable terms for the company.
  • Managed daily operations of the business including budgeting, forecasting, financial analysis, staffing, and customer service.

Medication Wellness Specialist

CVS Caremark
Remote

  • Assisted pharmacists in preparing medical records for submission to insurance companies for prior authorization approval.
  • Conducted follow-up calls with physicians' offices regarding incomplete or missing information on prescriptions.
  • Analyzed prior authorization request forms to determine appropriate coding before submission.
  • Verified patient demographic and insurance information to ensure accuracy of prior authorization requests.

Pharmaceutical Care Liaison

Humana Pharmacy Inc
Remote
  • Communicated effectively with physicians, nurses, patients and other healthcare professionals regarding medication needs or issues related to prescriptions.
  • Adhered to all HIPAA regulations regarding patient privacy and confidentiality.
  • Verified patient insurance coverage and eligibility for prescription medications.
  • Processed prescription orders using pharmacy software system.
  • Resolved customer complaints and concerns in a professional manner.

Customer Care Champion

Blue Cross and Blue Shield of Illinois
Remote
  • Documented customer correspondence in CRM to track requests, problems and solutions.
  • Analyzed customer complaints and service trends to identify and correct systematic issues.
  • Audited customer account information to identify issues and develop solutions.
  • Upheld high standards of customer services by responding to inquiries, needs and problems.
  • Assisted customers with product installation, troubleshooting, and usage questions.

Education

St. Louis Community College - Forest Park
01.2015

Clyde C Miller Career Academy
01.2014

Skills

  • Claims Investigation
  • Claims Processing
  • Risk Assessment
  • Policy Investigations
  • Medical Terminology Specialist
  • Conflict Resolution Techniques
  • Negotiation Abilities
  • HIPAA Compliance
  • Customer Complaint Resolution
  • Adaptability

Certification

  • Property & Casualty License

Timeline

Total Loss Claims Adjuster

Liberty Mutual Insurance Company
01.2023 - Current

Project Manager

Grow Ur Potential
01.2023 - Current

Total Loss Specialist

State Farm Mutual Automobile Insurance
01.2019 - 01.2023

Asset Protection Partner

Target Company
01.2017 - 01.2018

Medication Wellness Specialist

CVS Caremark

Pharmaceutical Care Liaison

Humana Pharmacy Inc

Customer Care Champion

Blue Cross and Blue Shield of Illinois

St. Louis Community College - Forest Park

Clyde C Miller Career Academy

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