Summary
Overview
Work History
Education
Skills
Timeline
Generic

Joseph Guidry

Houston,TX

Summary

Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty.

Driven insurance professional, prepared to bring extensive experience in claims analysis and resolution. Proven track record in handling intricate cases with precision and ensuring fair settlements. Valued team player with focus on results, known for adaptability and reliability.

Experienced with evaluating insurance claims and determining appropriate actions. Utilizes analytical skills to assess damage and liability. Strong understanding of policy coverage and effective negotiation techniques.

Skilled insurance professional ready to handle complex claims with precision and efficiency. Proven track record in thorough investigation, accurate assessment, and effective negotiation. Strong collaborator focused on team success and adaptable to changing environments. Expertise in customer communication, claims processing, and conflict resolution.

Knowledgeable [Desired Position] with solid background in analyzing claims and determining coverage. Successfully managed complex cases with focus on thorough investigation and timely resolution. Demonstrated proficiency in negotiation and customer service skills.

Machinery and Equipment Adjuster, performing precision assembling, adjusting, or calibrating. Repair, adjust or install all types of electric or gas household appliances, such as refrigerators, washers, dryers and ovens. Skilled in reading technical manuals, following diagrams and performing root cause analysis.

Overview

6
6
years of professional experience

Work History

Claims Resolution Adjuster – Remote

Direct Auto & Life Insurance
06.2024 - Current
  • Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
  • Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
  • Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
  • Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Contributed to team success by participating in regular training sessions, sharing best practices, and mentoring new adjusters.
  • Investigated and assessed damage to property and reviewed property damage estimates.
  • Examined claims forms and other records to determine insurance coverage.
  • Streamlined workflow for faster claim resolution by coordinating with various internal departments and external agencies.

Healthcare Customer Service Representative/Claims Representative

CareCentrix
01.2023 - 05.2024
  • Answering inbound calls, emails, and chats from customers regarding their healthcare claims. Providing clear and accurate information about claims status,
    benefits, and coverage.
  • Addressing customer inquiries, complaints, and feedback in a professional and courteous manner. Assisting customers with understanding their Explanation of Benefits (EOB) statements
  • Verifying claims information and ensuring completeness and accuracy. Coordinating with healthcare providers and insurance companies to resolve claims issue
  • Investigating and resolving claims discrepancies and issues. Researching denied or rejected claims to determine the reason and provide solutions.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
  • Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
  • Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
  • Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.

Enrollment Specialist

Sutherland Global
01.2021 - 01.2023
  • Respond to inbound calls and inquiries from individuals seeking information on healthcare plans and enrollment options.
  • Provide clear and accurate explanations of healthcare benefits, coverage options, and eligibility requirements.
    Assist customers in selecting the appropriate healthcare plan based on their needs and financial situation.
  • Guide customers through the healthcare enrollment process, including completing applications and submitting required documentation.
  • Verify customer information and ensure all data is accurately entered into the enrollment system. Meet or exceed performance metrics related to customer satisfaction, call handling time, and enrollment accuracy.

Customer Service Representative

Lowes Home Centers
10.2019 - 01.2021
  • Manage inbound calls related to product availability, store locations, order status, delivery options, and returns.
  • Assist customers in placing orders over the phone, including confirming product details, delivery times, and payment options.
  • Handle customer complaints, delivery issues, or product problems, working to provide effective solutions and escalating cases when necessary.
  • Assist customers with tracking their online or in-store pickup orders, offering updates on shipping or delivery times.

Education

High School Diploma -

Memorial High School

Skills

  • Insurance Verification
  • Appointment Scheduling
  • Call center experience
  • Claims Processing
  • Medical billing knowledge
  • HIPAA Compliance
  • Customer Service
  • EMR
  • Enrollment Verification
  • Problem-Solving
  • Decision-Making
  • Data Entry
  • Medical Billing
  • Benefit Verifications
  • Inbound/Outbound Calling
  • Customer Satisfaction
  • Client Relations
  • Call Center Operations
  • Customer Relationship Management (CRM)
  • ICD-10 Proficiency
  • HIPAA knowledge
  • Medicare Expertise
  • EOB Analysis
  • Claim Appeals Handling
  • Claims investigation
  • Damage assessment
  • Policy interpretation
  • Insurance regulations
  • Critical thinking
  • Property valuation
  • Quality control
  • Decision-making
  • Active listening
  • Claims processing
  • Risk assessment
  • CCC reports
  • Best practices implementation
  • Policy investigations
  • Sales background
  • Highly motivated
  • Team collaboration
  • Customer service
  • Property claims
  • Automobile appraisals
  • Claims file management processes
  • Claims adjustment

Timeline

Claims Resolution Adjuster – Remote

Direct Auto & Life Insurance
06.2024 - Current

Healthcare Customer Service Representative/Claims Representative

CareCentrix
01.2023 - 05.2024

Enrollment Specialist

Sutherland Global
01.2021 - 01.2023

Customer Service Representative

Lowes Home Centers
10.2019 - 01.2021

High School Diploma -

Memorial High School
Joseph Guidry