Summary
Overview
Work History
Education
Skills
Timeline
Hi, I’m

Keyana Wright

Mesa,AZ

Summary

Claims Specialist seeking role with14 years of experience in insurance industry. Extensive pharmacy claims experience as Pharmacy Technician, adept in managing Medicare D Plans. Proven track record in claims processing and resolution, skilled in analyzing and auditing insurance policies for accuracy and compliance.

Overview

19
years of professional experience

Work History

The Fairy Dusters

Cleaning Company Owner
11.2023 - Current

Job overview

  • Supervise commercial cleaning services for diverse businesses, enhancing quality and customer satisfaction
  • Manage staff effectively, maintaining a consistently low turnover rate
  • Establish and negotiate contracts with clients, while overseeing marketing efforts to attract potential new clients

Norwegian Cruise Line

Cruise Specialist
08.2023 - 11.2023

Job overview

  • Responded to client inquiries and resolved issues, maintaining a high level of customer satisfaction
  • Coordinated travel arrangements and accommodations for diverse client groups, including couples and large parties
  • Managed booking processes and prepared detailed billing statements for cruise reservations

Old Republic Risk Management Insurance

Account Service Coordinator
11.2021 - 07.2023

Job overview

  • Coordinated the setup, renewal, and cancellation of insurance policies, ensuring seamless account management through direct collaboration with account managers and executives
  • Developed and maintained detailed Excel spreadsheets to log policy information, enhancing both data accuracy and accessibility
  • Conducted internal audits and managed the creation, review, and distribution of insurance contracts, manuals, and surveys to optimize policy administration

United Healthcare

Operations Administrator
07.2017 - 10.2021

Job overview

  • Verified insurance coverage through telephone and online platforms to ensure accurate reimbursement and estimated patients' financial responsibilities
  • Scanned, indexed, and entered documents into electronic health records, maintaining accuracy and compliance with HIPAA standards
  • Processed claims
  • Managed and tracked outstanding insurance claims, ensuring timely resolution and communication with relevant stakeholders
  • Addressed inquiries and provided information to policyholders, facilitating understanding of insurance options and processes

Community Advocates

Energy Assistance Representative
08.2016 - 05.2017

Job overview

  • Managed a high-volume multi-line telephone system, independently handling over150 calls daily to facilitate appointment scheduling and customer inquiries, ensuring efficient communication and customer satisfaction
  • Educated customers on billing and payment processing, served as a liaison to resolve concerns, and coordinated with internal departments, while accurately recording customer interactions for effective account management and follow-up on collections

Direct Supply

Day Porter
05.2013 - 08.2016

Job overview

  • Maintained cleanliness and organization of building areas, with a focus on regularly sanitizing high-traffic zones to ensure optimal hygiene levels
  • Managed inventory by monitoring supply levels and placing timely orders to ensure availability of necessary cleaning materials
  • Ensured compliance with safety regulations and OSHA standards through consistent and reliable job performance

Nova1

Customer Service Operator
11.2012 - 01.2013

Job overview

  • Managed inbound communications for third-party clients, achieving high satisfaction ratings by proactively resolving customer issues in a single interaction
  • Utilized CRM database to document calls and educate customers on promotions while consistently meeting call-time and quality standards by handling over100 calls per shift

John Hancock Insurance Company, Stivers Staffing

Business Analyst
06.2010 - 09.2010

Job overview

  • Assessed customer applications and medical records requests by applying underwriting guidelines to ensure accurate insurance coverage evaluation
  • Communicated with clients to deliver detailed information on available products and coverage options while maintaining professionalism in high-pressure scenarios

Wells Fargo

Loan Processor
10.2009 - 06.2010

Job overview

  • Analyzed clients' financial data, including credit and income documents, to determine loan suitability and support informed underwriting decisions, while managing over100 calls per shift to maintain service quality
  • Facilitated borrower communication, explaining legal aspects and payment terms, and assisted with short sales and deed in lieu processes, ensuring adherence to company policies and achieving call-time and quality standards

National Government Service

Provider Service Clerk
01.2006 - 04.2007

Job overview

  • Verified client memberships and processed claims, ensuring documentation accuracy and validity on updated systems, while effectively following up on unresolved issues
  • Collaborated with the claims department and anti-fraud organizations to investigate and resolve potentially fraudulent claims initiated by claims representatives

Education

Gateway Technical College

HSED

University Overview

Skills

  • Customer Service Recommendations
  • Complaint Resolution
  • International Sales Support
  • Report Preparation
  • Account Updates
  • Customer Accounts Management
  • Billing Inquiries
  • Schedule Management
  • Recordkeeping Strengths
  • Creative Strategic Solutions Development
  • Inbound Call Management
  • Multi-Line Phone Talent
  • Problem-Solving
  • Communication
  • Conflict Resolution
  • Product Knowledge
  • Attention To Detail
  • Problem Solving
  • Analytical Skills
  • Microsoft Office
  • Teamwork

Timeline

Cleaning Company Owner
The Fairy Dusters
11.2023 - Current
Cruise Specialist
Norwegian Cruise Line
08.2023 - 11.2023
Account Service Coordinator
Old Republic Risk Management Insurance
11.2021 - 07.2023
Operations Administrator
United Healthcare
07.2017 - 10.2021
Energy Assistance Representative
Community Advocates
08.2016 - 05.2017
Day Porter
Direct Supply
05.2013 - 08.2016
Customer Service Operator
Nova1
11.2012 - 01.2013
Business Analyst
John Hancock Insurance Company, Stivers Staffing
06.2010 - 09.2010
Loan Processor
Wells Fargo
10.2009 - 06.2010
Provider Service Clerk
National Government Service
01.2006 - 04.2007
Gateway Technical College
HSED
Keyana Wright