Donesha Alford
Chicago,IL
Summary
Responsible and hardworking individual with experience performing detailed investigations and researching issues. Skilled at interpreting laws and analyzing facts. Provides exceptional customer service and enthusiastic about learning. Pursues opportunities to learn new skills and contribute to group success. Offers strong administrative, relationship-building and problem-solving abilities.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Claims Adjuster
Progressive Casualty Insurance Company
06.2021 - Current
- Manage a high volume of auto claim files from beginning to end, following up with vehicle owners, returning voicemails, email etc
- Resolve and document auto claims as quickly and accurately as possible, using data entry, excel
- Interview all involved in an accident, including witnesses to determine factual information and independently make decisions related to liability and coverages, Substantiated legitimate claims and denied unjustified claims.
- Examine photos, Validate damage is consistent with the accident/ police report of the accident
- Set live tow from scene, authorize rental cars, and make Direct contact with auto body shops to set up repair
Delivery Driver
Fedex Express
04.2018 - 06.2021
- Maintained upbeat, positive attitude in busy, customer-focused environment while operating a company vehicle
- Comply within DOT regulations
- Provides courteous and efficient delivery and pick-up of packages
- Checks shipments for conformance to FedEx features of service and provides related customer service functions
- Delivered packages to customer doorsteps and business offices.
- Complete daily paperwork, printing and faxing incoming/outgoing route information, Read maps, followed oral, and written instructions and used GPS technology to make deliveries.
Patient Access Rep
Northshore University Health Systems
04.2017 - 04.2018
- Collect information from patients and key data in EPIC
- Register and verify insurance eligibility, informing the patients of their financial responsibility
- Handle patient requests, over the phone, for multiple medical departments while using correct workflows and protocols
- Schedule appointments and route calls to appropriate department after assessing patients’ needs
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Customer Service Agent
CVS Health Specialty Care Center
08.2015 - 02.2017
- Provide telephone support to patients receiving life sustaining specialty drug therapy
- Discuss and receive chronic diagnosis, medication information and needs from patients, nurses and doctors via fax and verbal
- Translate and enter in new or refill prescriptions into the pharmacy information system
- Communicate and collect copay amounts obtain authorizations and work closely with insurance companies
- Utilization and understanding of medical terminology
Benefits Specialist
Aetna Health
02.2013 - 08.2015
- Answer phone queues and process faxes within established standards
- Verify eligibility and benefits
- Complete and submit applications, issue quotes and maintain records
- Explain features, advantages and disadvantages of various policies to promote sale of insurance
- Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list
- Route to appropriate staff when needed
Education
High School Diploma -
J Sterling Morton West
Berwyn12.2013
Associate of Science - Health Information Management
Kaplan University
Davenport, IA03.2016
Skills
- Excellent Writing Skills
- Fact-Finding
- Law Enforcement
- Time Management
- Regulatory Compliance
- Customer Service
- Data Entry
- Goal Oriented
- Microsoft Office Specialist Certified
Certification
Auto Adjusting License
DOT Certified
Timeline
Senior Claims Adjuster
Progressive Casualty Insurance Company
06.2021 - Current
Delivery Driver
Fedex Express
04.2018 - 06.2021
Patient Access Rep
Northshore University Health Systems
04.2017 - 04.2018
Customer Service Agent
CVS Health Specialty Care Center
08.2015 - 02.2017
Benefits Specialist
Aetna Health
02.2013 - 08.2015
High School Diploma -
J Sterling Morton West
Associate of Science - Health Information Management
Kaplan University