Gaylon McCowan
Ocala,FL
Summary
Remote-ready customer service and claims intake professional with a proven track record in supporting banking, insurance, and healthcare processes within high-volume environments. Expertise in managing inbound and outbound calls, ensuring real-time documentation accuracy, and maintaining compliance with HIPAA and other regulatory standards. Recognized for exceptional communication skills, adept de-escalation techniques, and the ability to navigate multiple systems efficiently to resolve issues and advance cases. Committed to delivering outstanding service while fostering positive relationships with clients and stakeholders.
Overview
10
10
years of professional experience
Work History
Claims Intake Representative
Illumifin
01.2025 - 01.2026
- Delivered exceptional customer service support by handling incoming calls and inquiries related to claims with empathy, accuracy, and professionalism.
- Performed accurate data entry of claim information into internal systems while maintaining a high level of attention to detail.
- Collected and verified policyholder information to initiate the claims process in compliance with internal procedures.
- Guided clients through documentation requirements, ensuring smooth claim intake and proper follow-up communication.
- Adhered strictly to HIPAA regulations and company privacy standards when handling sensitive customer data.
- Collaborated with internal teams to resolve complex or delayed claims, ensuring timely processing and communication.
- Identified inconsistencies in claim submissions and escalated potential issues for further review and investigation.
- Maintained accurate records of all claims activities, including call notes, status updates, and follow-ups.
- Demonstrated strong multitasking skills by managing high call volumes while completing real-time data entry.
- Ensured compliance with all policy guidelines, standard operating procedures, and state or federal regulations.
- Initiated first notice of loss (FNOL) for new claims, capturing detailed incident information to begin the adjudication process.
- Verified policy coverage and eligibility criteria to determine appropriate claim routing and next steps.
- Communicated with third-party providers and adjusters to facilitate efficient documentation gathering and status updates.
- Utilized multiple systems and databases to input, track, and manage high volumes of claims with accuracy.
- Ensured all intake forms were completed in accordance with regulatory and internal documentation standards.
- Followed up with customers, providers, or agents to resolve missing or unclear information, reducing delays in claims processing.
- Participated in routine audits and quality checks to maintain consistent HIPAA compliance and data privacy protocols.
- Trained in handling sensitive and confidential information with discretion while processing claim documents and updates.
- Prioritized workload based on claim severity and urgency, managing daily queues while meeting processing timelines.
- Supported team efforts during high-volume periods by assisting with overflow claims and intake support across departments.
Bank Customer Service Representative (Remote)
Jack Henry
01.2024
- Provided remote frontline support for financial institution customers, resolving account and digital banking inquiries in a high-volume environment.
- Troubleshot online banking access (password resets, account unlocks, navigation support) while following authentication and security procedures.
- Documented interactions and resolutions clearly and consistently to support follow-up, auditing, and customer experience continuity.
- Researched accounts and transactions using proprietary systems to identify root cause and provide accurate, compliant resolutions.
- Supported transaction-related requests (stop payments, balance inquiries, funds transfers, and transaction verification) with strong attention to detail.
- Maintained compliance with banking regulations, internal procedures, and data security standards; escalated complex issues when needed.
Customer Sales Representative
Direct Energy
01.2016 - 01.2024
- Delivered high-quality customer service by assisting clients with account inquiries, service options, and billing concerns in a fast-paced call center environment.
- Promoted energy products and services to new and existing customers, consistently meeting or exceeding daily sales goals.
- Handled inbound and outbound calls to educate customers on energy plans, pricing, and benefits tailored to their household needs.
- Processed new service requests, plan changes, and disconnections while ensuring all account updates were entered accurately.
- Resolved billing discrepancies and provided detailed explanations of charges, usage, and payment options.
- Maintained compliance with state regulations, company policies, and energy market standards during every interaction.
- Demonstrated empathy and professionalism when assisting customers during outages, rate changes, or high-usage periods.
- Updated and verified customer account information, including contact details, service addresses, and payment methods.
- Used CRM systems to track customer interactions, document resolutions, and support team-based performance metrics.
- Strengthened customer relationships by providing consistent, reliable support and presenting service upgrade opportunities.
Education
Diploma -
South Garland High School
Skills
- Customer Support
- Claims / Insurance
- Banking Operations
- Healthcare Support
- Documentation & Process
- Performance & Collaboration
- Data entry proficiency
- Complaint handling
- Financial transactions
- Loan processing
Timeline
Claims Intake Representative
Illumifin
01.2025 - 01.2026
Bank Customer Service Representative (Remote)
Jack Henry
01.2024
Customer Sales Representative
Direct Energy
01.2016 - 01.2024
Diploma -
South Garland High School
REMOTE WORK & TECHNOLOGY
- Remote customer support experience (phone, email/chat support) with strong time management and accountability
- Comfortable working across multiple applications simultaneously (data entry, account research, documentation, and status updates)
- Performance-driven: call handling, adherence, quality, accuracy, and customer satisfaction in a high-volume queue environment
- Privacy and security focused: HIPAA awareness, confidential data handling, and policy/SOP adherence