Summary
Overview
Work History
Education
Skills
Timeline
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Gayla Salter

Columbus,MS

Summary

Detail-oriented claims processor with proven skills in claims analysis, fraud detection, and documentation review. Experienced in premium calculation and customer service, dedicated to maintaining confidentiality and ensuring compliance with industry regulations.

Overview

8
8
years of professional experience

Work History

Claims Processor

Cognizant TCO
Jackson, MS
08.2021 - 07.2025
  • Reviewed claim documentation for accuracy and completeness.
  • Communicated with clients to gather additional information as needed.
  • Analyzed claim data to identify trends and potential fraud indicators.
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Used insurance rate standards to calculate premiums, refunds, commissions and adjustments.
  • Maintained confidentiality of policyholder information in compliance with HIPAA regulations.

Senior Claim Benefit Specialist

CVS Healthcare
Montgomery, Alabama
06.2019 - 08.2021
  • Collected payments, processed receipts and informed policyholders of outstanding balances.
  • Organized information by using spreadsheets, databases or word processing applications.
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Maintained detailed records of all activities related to claims processing including hearing requests, decision letters.

Customer Service Representative

Omni Interactions
Denver, Colorado
02.2017 - 06.2020
  • Documented customer interactions in the CRM system for tracking purposes.
  • Managed customer inquiries through phone and chat support channels.
  • Answered customer inquiries and provided accurate information regarding products and services.
  • Developed positive relationships with customers through friendly interactions.

Education

High School Diploma -

New Hope High School
Columbus, MS
05-2016

Skills

  • Claims analysis
  • Policy interpretation
  • Documentation review
  • Fraud detection
  • Premium calculation
  • Insurance regulations
  • Problem solving
  • Attention to detail
  • Data organization
  • Time management

Timeline

Claims Processor

Cognizant TCO
08.2021 - 07.2025

Senior Claim Benefit Specialist

CVS Healthcare
06.2019 - 08.2021

Customer Service Representative

Omni Interactions
02.2017 - 06.2020

High School Diploma -

New Hope High School

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