Janika Watts
Detroit,MI
Summary
Claims professional with extensive experience in managing and resolving insurance claims. Recognized for delivering high-quality service and achieving positive resolutions. Known for exceptional teamwork, adaptability, and proficiency in claims processing and customer service.
Overview
6
6
years of professional experience
Work History
Sr. Disability Claim Specialist
Sedgwick
02.2022 - Current
- Review incoming claims for accuracy and completeness in accordance with policy provisions.
- Respond to inquiries from claimants, attorneys, medical providers. regarding the status of their claim.
- Maintain timely and accurate records of all claim activity.
- Assist in the development of new processes for handling claims more effectively.
- Participate in special projects as assigned by management team.
- Provide excellent customer service throughout the entire claims process.
- Develop effective relationships with customers through communication via phone or email.
- Ensure that all documentation was accurately entered into the system.
- Review policies and procedures regularly to ensure they are up-to-date with industry standards.
- Process payments accurately according to established timelines.
- Process claims for payment or forwarded to appropriate personnel for further investigation
- Examine claims, records and procedures to grant approval of coverage.
ADA Accommodations Coordinator
Sedgwick
06.2020 - 02.2024
- Conducted initial employee interview per process guidelines
- Informed claimants of the documentation required to process claims, the required time frames, and claims status either by phone, written correspondence, and/or the claims system.
- Reviewed medical information to determine if the claimant met the requirements under the ADA, state, and/or client requirements for a qualifying condition.
Subrogation Customer Service Representative
Equiqan
08.2019 - 05.2020
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Gathered customer feedback through surveys and used the data to improve customer service.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Developed strong relationships with customers by providing personalized assistance and support.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Answered inbound calls, chats and emails to facilitate customer service.
Education
Bachelor of Science -
Michigan State University
East Lansing, MISkills
- Claims analysis
- Data quality assurance
- Effective problem resolution
- Effective relationship management
- Strong numerical aptitude
- Adaptability to change
- Strong attention to detail
- Proficient in computer applications
- Effective communication skills
- Collaborative team member
- Flexible problem-solving
- Critical analysis
- Strategic decision-making
Education and Training
other
Timeline
Sr. Disability Claim Specialist
Sedgwick
02.2022 - Current
ADA Accommodations Coordinator
Sedgwick
06.2020 - 02.2024
Subrogation Customer Service Representative
Equiqan
08.2019 - 05.2020
Bachelor of Science -
Michigan State University
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