Doreathea Jones
Zebulon,NC
Summary
The ability to provide claim support. Reviewing, analyzing and researching complex claims. Providing keen attention to detail and ensuring quality work. Meeting daily and weekly production.
Overview
7
7
years of professional experience
Work History
Claims Customer Service Representative Sr
WellMed Medical Management - UHG
08.2022 - Current
- Improved workflow efficiency with proficient multitasking and prioritization of high-priority cases.
- Generated, posted and attached information into tracking system and attached notes to claim files.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Promptly answered incoming phone calls to assist with claims.
- Navigate complex computer applications
- Productive in metric-based environment.
Customer Relations Manager
Progressive Insurance
01.2018 - 08.2022
- Process payments, go over coverages and explain to the customer
- Delegated tasks to existing support team members and used cloud-based tools to help solve complex business issues.
- Add, replace and remove vehicles and or drivers
- Process any documents per guidelines for their effective dates
- Assist with adding state filings(Sr22 and Fr44) Policy reviews and assist with renewal questions as to rate adjustments and providing quotes.
- Handled complaints, provided appropriate solutions, and alternatives within appropriate timeframes and followed up to achieve resolution.
- High volume environment handling over 100 calls per day.
Customer support
Diligence LLC
02.2017 - 07.2021
- Provided exceptional customer support, addressing concerns in a timely manner to maintain client satisfaction.
- Implemented efficient scheduling practices, optimizing staff coverage during peak hours for optimal customer support.
- Met all Metrics
- Efficiently worked and resolved each call in a timely manner
Education
Associate of Science - Criminal Justice
Wake Technical Community College
Raleigh, NCHigh School Diploma -
Smithfield-Selma High School
Smithfield, NC06.2007
Skills
- Microsoft Office Suite :Outlook, Word, Excel
- Navigate complex computer systems
- High volume environment
- Metric Based environment
- Medical claims experience
- Conflict resolution
- Disciplined
- Communicate Effectively
- 50 WPM
- Medical office assistant
Timeline
Claims Customer Service Representative Sr
WellMed Medical Management - UHG
08.2022 - Current
Customer Relations Manager
Progressive Insurance
01.2018 - 08.2022
Customer support
Diligence LLC
02.2017 - 07.2021
Associate of Science - Criminal Justice
Wake Technical Community College
High School Diploma -
Smithfield-Selma High School
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