Makeda Sinclair
Fort Lauderdale,FL
Summary
Professional in claims management, prepared to lead and enhance claims operations. Strong focus on team collaboration and achieving impactful results. Skilled in analyzing claims, resolving discrepancies, and ensuring compliance with regulations. Reliable and adaptable, consistently meeting evolving needs and challenges. Effective communicator with keen eye for process improvement and proactive approach to problem-solving.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Claims Supervisor
First Health
08.2021 - Current
- Documented and communicated timely claims information while supporting accurate outcomes.
- Gathered sensitive information to update customer profiles and help with appeals process.
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Increased accuracy in claim evaluations through comprehensive documentation and attention to detail.
- Achieved high customer satisfaction ratings by maintaining open lines of communication and addressing concerns promptly.
Claims Representative
First Health
02.2021 - 08.2021
- Followed up with members on unresolved issues.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Responded to provider inquiries, providing detailed explanations of insurance policies and claims processes.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Front Desk Supervisor
Home 2 Suites
11.2019 - 02.2021
- Trained new employees on front desk operations, ensuring they were well-prepared for their roles and responsibilities.
- Enhanced guest satisfaction by efficiently managing front desk operations and addressing customer inquiries promptly.
- Collected room deposits, fees, and payments.
- Coordinated with room service, housekeeping, maintenance, and security to meet all guest needs.
- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
Customer Service Representative
Sitel
07.2017 - 10.2019
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Improved resolution time with effective problem-solving for customer complaints.
Sales Associate
Old Navy
03.2016 - 06.2017
- Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
- Handled cash transactions efficiently while adhering to company cash handling policies, ensuring accuracy in all financial exchanges.
- Managed returns, exchanges and refunds in accordance with store policy.
- Helped customers locate products and checked store system for merchandise at other sites.
- Answered customer questions about sizing, accessories, and merchandise care.
Education
Medical Technology
Broward College
Fort Lauderdale, FLSkills
- Claims management expertise
- Willing to learn
- Teamwork and collaboration
- Problem-solving abilities
- Reliability
Certification
- Certified Medical Technician
- Quality Assurance
- Microsoft Software
Timeline
Claims Supervisor
First Health
08.2021 - Current
Claims Representative
First Health
02.2021 - 08.2021
Front Desk Supervisor
Home 2 Suites
11.2019 - 02.2021
Customer Service Representative
Sitel
07.2017 - 10.2019
Sales Associate
Old Navy
03.2016 - 06.2017
Medical Technology
Broward College