ERICA N. CREWS
Columbus,GA
Summary
Personable and dedicated professional with extensive customer service experience. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
17
17
years of professional experience
Work History
Claims Representative
American Family Insurance
01.2024 - Current
- Processed claims efficiently, ensuring compliance with policy guidelines and regulatory requirements.
- Analyzed claim submissions for accuracy and completeness, reducing errors in documentation.
- Coordinated communication between clients and insurance adjusters to expedite claim resolutions.
- Conducted investigations into complex claims, collaborating with stakeholders to gather necessary information.
Customer Service Advocate
Humana
12.2020 - Current
- Responsibilities include handling incoming calls regarding membership inquiries, claims, and billing issues.
- Ensure prompt and accurate resolution of complex concerns.
- Process Grievance and Appeals cases in compliance with HIPAA and ERISA regulations.
- Assist members with their healthcare needs and inquiries via phone, email, and chat.
- Research and resolve member issues in a timely and professional manner.
CSR - Claims Coordinator
Allstate Insurance
01.2020 - Current
- Receive and review claim applications, ensuring that all required information and documentation are complete and accurate. Verify policy coverage, eligibility, and any other relevant details to determine the validity of the claim.
- Maintain organized and up-to-date records of all claims, including claim forms, supporting documents, correspondence, and other relevant information. Ensure that all documentation complies with internal procedures and regulatory requirements.
- Serve as a primary point of contact for claimants, policyholders, and other stakeholders.
- Communicate effectively and professionally, providing updates on claim status, requesting additional information if necessary, and addressing inquiries and concerns.
Assistance Coordinator
Road America Motor Club
01.2009 - 01.2014
- Receive incoming calls from members and service providers regarding emergency towing assistance requests. Evaluate the urgency and nature of each request and assign appropriate resources for prompt response.
- Monitor and maintain satisfactory levels of productivity by efficiently handling dispatches and minimizing dispatch cycle time. Optimize resource allocation and coordinate with service providers to ensure timely response to member requests.
- Assess each dispatched request to ensure accurate assignment of appropriate service providers based on location, availability, and required services. Make necessary adjustments or reassignments as needed.
- Handle and resolve issues or concerns related to dispatches, including service delays, breakdowns, or member dissatisfaction.
Education
High School Diploma -
Carver High School
01.2005
Skills
- Customer Service-Oriented
- Multitasking & Prioritizing
- Skilled Collaborator
- Critical Thinking
- Computer & Software Skills
- Verbal & Written Communication
- Time Management
- Efficient and Detail-Oriented
- Documentation and Reporting
- Customer Account Management
- Customer Retention Strategies
- Creative Problem Solving
- Transaction Processing
- Inbound and Outbound Calling
- Benefits Verification
- De-escalation Techniques
- Upselling Products and Services
- Live Chat Messaging
- Process Improvement
- Data Entry
- 10 Key Certified
- Claims Processing
- Payment Posting
- Insurance Verification
- Medical Billing & Coding
- CPT & ICD-10 CM Codes
- Appeals & Grievances
- ICD-9
Timeline
Claims Representative
American Family Insurance
01.2024 - Current
Customer Service Advocate
Humana
12.2020 - Current
CSR - Claims Coordinator
Allstate Insurance
01.2020 - Current
Assistance Coordinator
Road America Motor Club
01.2009 - 01.2014
High School Diploma -
Carver High School