Evelyn Nicholson
Summary
Dynamic professional with extensive experience at Florida Blue Health Insurance, excelling in claims processing and client communication. Proven ability to resolve discrepancies and enhance customer satisfaction through analytical problem-solving and collaborative teamwork. Proficient in data accuracy and entry, ensuring compliance and efficiency in all operations.
Overview
10
10
years of professional experience
Work History
Claims Processor/Customer Service Representative
Florida Blue Health Insurance
07.2024 - Current
- Processed claims accurately, adhering to internal guidelines and systems.
- Communicated with policyholders to clarify claim details through written correspondence.
- Collaborated with healthcare providers to verify treatment information effectively.
- Investigated discrepancies in claims and resolved issues promptly.
- Maintained detailed records of processed claims and client communications.
- Updated claims tracking systems to reflect current statuses and relevant notes.
- Ensured compliance with quality and production standards during claims processing.
- Assisted customers via telephone inquiries regarding claim status and services.
Account Manager
Capital Group Investments/American funds
11.2022 - 06.2024
- Managed inbound calls from financial advisors and investors to address inquiries.
- Processed applications for new accounts efficiently, ensuring timely setup.
- Issued checks and mailed tax documents, maintaining compliance with regulations.
- Discussed investment fund performance details to provide accurate updates.
- Advised investors on 401(k), college savings, and retirement accounts, enhancing financial literacy.
- Placed outbound calls to service departments and investors for follow-up actions.
- Utilized ICD-9 codes for accurate documentation of client interactions.
Account Manager
PNC Bank
03.2020 - 10.2022
- Handled over 95 daily customer inquiries through phone and chat regarding business banking.
- Supported account openings and upgrades, improving client satisfaction.
- Aided customers with loan applications for streamlined processing.
- Established Online Banking accounts to enhance user experience.
- Developed ongoing relationships with clients through proactive communication.
- Evaluated client needs to propose relevant financial products.
- Recorded all customer interactions accurately in the CRM system.
- De-escalated issues effectively by suggesting alternative solutions during interactions.
Account Specialist
Partners In Asset Recovery
10.2018 - 03.2020
- Acted as primary liaison for Finance Company, customers, and recovery agents.
- Supplied repossession agents with accurate vehicle location information.
- Conducted inbound and outbound calls to clients and debtors for effective communication.
- Processed client documents promptly to support operational efficiency.
- Supported email inbox management to improve client engagement.
- Executed data entry responsibilities with precision.
- Documented client interactions and resolutions thoroughly to track service quality.
- Worked alongside departments to resolve discrepancies in customer accounts.
Customer Service
Liberty Mutual
03.2017 - 10.2018
- Managed over 65 daily inbound calls for customer assistance with policy updates.
- Processed auto and renters insurance claims with necessary follow-ups.
- Oversaw customer service representatives, maintaining high-quality service levels.
- Conducted team meetings to foster communication and enhance collaboration.
- Efficiently addressed inquiries via chat queue, ensuring timely support.
- Prioritized client satisfaction while delivering outstanding customer service.
Medical Coder
Zotec Partners
06.2016 - 03.2017
- Maintained accurate health insurance information for patients to facilitate billing processes.
- Conducted thorough data entry into medical records systems.
- Processed medical bills submitted to insurance companies for prompt payment.
- Ensured correct coding on medical bills by reviewing details diligently.
- Managed mailing of physician's bills to customers based on address records.
- Analyzed medical records for precise coding and regulatory compliance.
- Reviewed patient documentation for accuracy and proper coding standards.
- Collaborated with healthcare providers to address and resolve coding issues swiftly.
Education
High School Diploma -
Lawrence Central
Indianapolis, IN06-2013
Some College (No Degree) -
Ivy Tech Community College of Indiana
Indianapolis, INSkills
- Typing proficiency
- Analytical problem solving
- Collaborative teamwork
- Payment posting and processing
- Claims handling
- Client communication
- Data accuracy and entry
- Call center experience
- Effective writing skills
- Leadership qualities
- Communication capabilities
- Microsoft Office applications
Timeline
Claims Processor/Customer Service Representative
Florida Blue Health Insurance
07.2024 - Current
Account Manager
Capital Group Investments/American funds
11.2022 - 06.2024
Account Manager
PNC Bank
03.2020 - 10.2022
Account Specialist
Partners In Asset Recovery
10.2018 - 03.2020
Customer Service
Liberty Mutual
03.2017 - 10.2018
Medical Coder
Zotec Partners
06.2016 - 03.2017
High School Diploma -
Lawrence Central
Some College (No Degree) -
Ivy Tech Community College of Indiana