Erik Reid
Summary
Detail-oriented Examiner with 10 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and review of detailed matters.
Overview
10
10
years of professional experience
Work History
Lead Claims Review Analyst
Highmark, Inc.
09.2018 - Current
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Identified key areas not performing well and implemented effective, new processes.
Claims Adjuster
Highmark, Inc.
08.2016 - 09.2018
- Examined claims forms and other records to determine insurance coverage.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Substantiated legitimate claims and denied unjustified claims.
Customer Service Representative
Highmark, Inc.
08.2014 - 08.2016
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Education
Bachelor of Science - Business Administration And Management
Robert Morris University
Coraopolis, PA05.2014
Skills
- Service Quality
- Claims Review
- Customer Needs Assessments
- Customer Satisfaction
- Strong Communication Skills
- Collaboration and Teamwork
- Problem Solving Prowess
Accomplishments
- Collaborated and part of implementation of High dollar Sharepoint to drive down volume and accurately capture volume and age of claims.
- Included in trainings and preparation for West Virginia line of business involving HRP system, OnBase, SDS and Bluesquared
Timeline
Lead Claims Review Analyst
Highmark, Inc.
09.2018 - Current
Claims Adjuster
Highmark, Inc.
08.2016 - 09.2018
Customer Service Representative
Highmark, Inc.
08.2014 - 08.2016
Bachelor of Science - Business Administration And Management
Robert Morris University