GABRIELLE JOHNSON
Luling,LA
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
8
8
years of professional experience
Work History
Claims Adjuster
Endurance Warranty Services LLC
10.2023 - Current
- Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
- Demonstrated expert knowledge of auto insurance policies and coverages, allowing for accurate assessment of damages and appropriate claim payouts.
- Provided exceptional customer service at all stages of the claims lifecycle while adhering to strict confidentiality guidelines regarding sensitive client information.
- Negotiated with claimants to settle claims.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Examined photographs and surveillance and any other documents relating to claims.
- Posted payments to accounts and maintained records.
- Calculated adjustments, premiums and refunds.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Improved customer satisfaction by efficiently processing auto claims in a timely manner.
- Learned and adapted quickly to new technology and software applications.
- Accelerated claims review process, ensuring timely payments and customer support.
- Managed portfolio of claims from initiation to closure, ensuring all customer interactions were handled professionally.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Investigated and assessed damage to property and reviewed property damage estimates.
Billing and Collections Specialist
Service Corporation International
08.2022 - 09.2023
- Maintained accurate financial records, ensuring all transactions were properly documented and filed.
- Improved billing accuracy by diligently reviewing and verifying invoice data.
- Streamlined the billing process, reducing errors and increasing overall productivity.
- Participated in ongoing training sessions, staying up-to-date on best practices in billing and collections processes.
- Analyzed aging reports to identify trends in late payments and develop targeted collection efforts.
- Counseled debtors on payment options and arranged installment agreements.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Negotiated re-payment plans by identifying causes of delinquent payments to assist in recovery of debt and meet realistic timeframes.
- Managed high-volume accounts, prioritizing workloads to ensure timely processing of invoices.
- Negotiated to collect balance in full.
- Entered client details and notes into system for interdepartmental access and review.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Worked well in a team setting, providing support and guidance.
- Generated and distributed monthly customer statements.
BANK TELLER
TOTAL CHOICE FEDERAL CREDIT UNION
06.2022 - 01.2023
- Learned about customer's financial needs, established trust, and optimized sales opportunities resulting in quality customer service.
- Managed high-volume transactions during peak hours while maintaining attention to detail, ensuring seamless customer experience.
- Balanced cash drawers accurately at the end of each shift, minimizing discrepancies in financial records.
- Identified sales opportunities and referred customers to branch partners in financial services.
- Disbursed cash and checks accurately while maintaining security of cash drawers.
- Completed highly accurate, high-volume money counts via both manual and machine-driven approaches.
- Counted, verified and handled bank deposits and armored car transactions.
- Educated customers on online banking and mobile banking applications.
- Placed orders for customer checks and verified starting numbers.
- Assisted customers with compromised debit cards and issued new credentials.
- Monitored and verified suspicious activity on customer accounts.
- Maintained up-to-date knowledge of bank products, services, promotions, policies, regulations to better assist customers with their financial needs.
- Worked effectively in fast-paced environments.
- Self-motivated, with a strong sense of personal responsibility.
REMOTE CUSTOMER SERVICE REPRESENTATIVE
SLEEP NUMBER
08.2018 - 04.2020
- Responded to customer requests for products, services, and company information.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Identified and resolved discrepancies and errors in customer accounts.
- Participated in training programs to enhance product knowledge and customer service skills.
- Maintained detailed records of customer interactions and transactions, ensuring accurate documentation and follow-up.
- Coordinated with logistics department to expedite shipping for urgent customer orders.
- Scheduled deliveries for bed installations and troubleshooting for mechanical reasons.
PATIENT SERVICE REPRESENTATIVE-OUTBOUND
TRIWEST HEALTHCARE ALLIANCE
08.2016 - 09.2017
- Worked collaboratively with VA and providers to obtain medical documentation to efficiently process authorizations
- Actively participated in team meetings focused on improving workflows and enhancing overall practice performance.
- Contacted Veterans directly to obtain appointment preferences and provide appointment information
- Documented all communications involving Veteran and provider contacts
- Complied with HIPAA regulations to protect privacy of beneficiaries' health information
- Consistently meets department productivity and performance metrics
- Coordinated complete resolution of service issues by interfacing with the TriWest Complaints & Grievance Specialist and other departments when requested
- Managed multiple tasks list in accordance with directed timelines
- Worked long/ extended hours to achieve and maintain high performance
- Worked in unison with Complex Authorization Specialist to accurately process authorization to prevent future claim issues or delayed Veteran care
- Requested Medical Records from providers for care that already occurred
- Scheduled veterans within contractual guidelines
- Appointed urgent authorization to prevent delay of care for Veterans and prevent negative impact to company goals
- Processed inquiries regarding referrals, authorizations, and credentialing of providers for healthcare services
- Contacted providers to initiate, schedule, and/or cancel Veterans' appointments
- Initiated outbound calls to Veterans to verify insurance coverage and personal preferences for scheduling
Education
ASSOCIATE DEGREE - BUSINESS OFFICE ADMINISTRATION
RIVER PARISH COMMUNITY COLLEGE
Gonzales, LA05.2022
HIGH SCHOOL DIPLOMA - CORE 4
HAHNVILLE HIGH SCHOOL
Boutte, LA05.2015
Skills
- Claims Investigation
- Highly motivated
- Claims Processing
- Advanced oral and written communication skills
- Data Analysis
- Payment Processing
- Computer Skills
- MS Office
Timeline
Claims Adjuster
Endurance Warranty Services LLC
10.2023 - Current
Billing and Collections Specialist
Service Corporation International
08.2022 - 09.2023
BANK TELLER
TOTAL CHOICE FEDERAL CREDIT UNION
06.2022 - 01.2023
REMOTE CUSTOMER SERVICE REPRESENTATIVE
SLEEP NUMBER
08.2018 - 04.2020
PATIENT SERVICE REPRESENTATIVE-OUTBOUND
TRIWEST HEALTHCARE ALLIANCE
08.2016 - 09.2017
ASSOCIATE DEGREE - BUSINESS OFFICE ADMINISTRATION
RIVER PARISH COMMUNITY COLLEGE
HIGH SCHOOL DIPLOMA - CORE 4
HAHNVILLE HIGH SCHOOL
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