Eboni Russell
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
13
13
years of professional experience
Work History
ACE Tutor
Texans Can Academy
04.2023 - Current
- Collaborated with students to complete homework assignments, identify lagging skills, and correct weaknesses.
- Provided homework assistance using specific curriculum and materials.
- Motivated students towards learning and studying to build self-confidence and reduce fear of failure.
- Schedule outside opportunities and programs. for future success
- Maintain program documentation in accord ACE Program record keeping standards
Retention Specialist
State Farm
06.2022 - Current
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Detailed payment options and explained price, receipt and billing details to customers.
- Adhered to all regulations for insurance sales.
- Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
Case Manager/Negotiator
Godsey Martin P.C
11.2018 - 06.2020
- Manage bodily injury claims from beginning to settlement
- Act as the single point of contact for all clients from beginning to settlement
- Maintain timely contact and updates with clients
- Provide thorough and timely updates to the attorney
- Coordinate client medical appointments and treatment
- Build value in the case during the treatment phase
- Ensure Letters of Representation and Letters of Protections are issued timely
- Set up first party and third-party liability claims in a timely manner
- Document all conversations, witness statements, medical documents, and correspondence
- Effective written and oral communication with client, adjusters, and attorneys.
Non-Subscription Adjuster
Gallagher Bassett
04.2016 - 11.2018
- Thoroughly and efficiently investigate the details of non-subscription ERISA injury claims by gathering information to determine liability exposure, assign reserves, negotiate, and settle 3rd party liability claims up to the designated authority level
- Clearly communicate concise action plans, and present plans for moving the case to conclusion
- Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim for both attorney represented, and non-attorney represented claims
- Attend and participate in mediation when appropriate
- Demonstrated ability to comply with carrier reporting and threshold requirements
- Processes claims consistent with clients' and corporate policies, procedures and "bestpractices" and in accordance with any statutory, regulatory and ethics requirements
- Deliver a customer-focused claim experience
- Resolved complex accounts.
Non-Subscription Adjuster III
Arkansas Claims Management, Inc
05.2013 - 04.2016
- Efficiently investigate the details of non-subscription ERISA injury claims by gathering information to determine liability exposure, assign reserves, negotiate, and settle 3rd party liability claims up to the designated authority level, while recognizing and reporting excess exposure
- Expertly determine benefits based on federal guidelines, examine coverage and process denials as well as coordinate litigation management and claim appeals
- Collaborates with store personnel, medical professionals, and vendor intermediaries to provide outstanding customer service and direct medical care for injured associates
- Utilizes appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients and manage claim recoveries of all types.
Senior Claims Examiner
Silverback, LLC
10.2011 - 05.2013
- Accurately processed professional and facility claims including specialist and long-term care claims for Medicare replacement plans
- Adeptly maintained quality and production standards while consistently meeting federal plan guidelines and deadlines
- Interfaced with providers, vendors and clients regarding claim status and benefit evaluation while providing excellent customer service.
Claims Analyst
Health Alliance Medical Plans
08.2010 - 10.2011
- Accurately processed medical, dental, orthodontia, accident and pharmacy claims for Ace and Cigna Insurance Companies
- Effectively interpreted and administered a wide variety of reimbursement methodologies, benefit plan designs including student business, employer/member contracts and Medicare pricing methodologies
- Thoroughly investigated and determined coverage applications, pre-existing diagnoses, processed adjustments, and refunds.
Education
Associate of Applied Science -
Dallas College
Dallas, TX05.2023
No Degree - Certified Nurse Assistant
Elite Medical Academy
Fort Worth, TX05.2010
Skills
- Problem-Solving Skills
- Verbal and Written Communication
- Creative Thinking
- Microsoft Office
- Maintain Records
- Negotiation
- Programming
- Data Entry and Analysis
- Judgment and Decision-Making
- Case Management Tracking
- Call Center Operations
- Case Preparation
Timeline
ACE Tutor
Texans Can Academy
04.2023 - Current
Retention Specialist
State Farm
06.2022 - Current
Case Manager/Negotiator
Godsey Martin P.C
11.2018 - 06.2020
Non-Subscription Adjuster
Gallagher Bassett
04.2016 - 11.2018
Non-Subscription Adjuster III
Arkansas Claims Management, Inc
05.2013 - 04.2016
Senior Claims Examiner
Silverback, LLC
10.2011 - 05.2013
Claims Analyst
Health Alliance Medical Plans
08.2010 - 10.2011
Associate of Applied Science -
Dallas College
No Degree - Certified Nurse Assistant
Elite Medical Academy
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