Lagaudia Hammond
Hephzibah,GA
Summary
Im an Experienced Claims Representative with background in insurance, healthcare, and customer service. Strengths include strong analytical skills, ability to handle multiple tasks efficiently, and exceptional communication abilities. known for high productivity and efficient task completion. Specialized skills include claim investigation, negotiation, and customer service. Excel in communication, empathy, and problem-solving to effectively manage claims and support policyholders. Committed to delivering accurate and timely resolutions in fast-paced environments.I’m
Overview
12
12
years of professional experience
Work History
CLRU Claim's Representative
Progressive Casualty Insurance
Cleveland , OH
06.2022 - Current
- Process claims for auto, personal property damages and catastrophic events.
- schedule repairs and rentals
- Personal injury protection (PIP), bodily injury, or medical claims adjuster jobs
- Commercial vehicle and specialized vehicle (motorcycle, boat, RV, etc.)
- Answering questions, reviewing policies and other documents to provide guidance to endorse claims are submitted in the proper manner to help ensure prompt and efficient processing.
- Educated customers on their rights under state and federal regulations governing insurance policies.
Benefit Enrollment Specialist
TELEPERFORMANCE
Augusta, GA
10.2016 - 05.2021
- Communicate product and related data specifications to platform vendors. Perform perpetual processing of enrollment data.
- Communicates claim action with claimant and client
- Ensures claim files are properly documented and claims coding is correct
- May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments.
Claims specialist
Sedgwick
11.2020 - 01.2021
- Processes low level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level
- Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments
- Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract
- Administers subrogation of claims and negotiates settlements
- Communicates claim action with claimant and client
- Ensures claim files are properly documented and claims coding is correct
- May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review
- Maintains professional client relationships.
Administrative Assistant (Temp)
Ntt data
Augusta, GA
08.2019 - 11.2019
- Perform clerical, administrative and office duties of a responsible and confidential nature
- Route and answer correspondence
- Independently establish, organize and maintain files and initiate follow up as needed
- Compile, analyze and summarize statistics and information
- Communicate new policies and procedures to the department and coordinate the gathering of information as directed.
billing specialist
Capture NET
01.2019 - 06.2019
- Responsible for the daily operation, planning, direction and supervision of government/non-government billing, collection, follow-up of all associated Hospital related charges
- The roles and responsibilities of this job support the mission, vision, values and strategies of AUMC
- Responsible for planning, organizing, implementing and maintaining operational plans, systems and initiatives in the following areas: Responsible for timely, accurate and effective billing of all hospital revenues and related collection activity
- Responsible for implementing, maintaining and monitoring policies, procedures and systems to ensure proper, timely, and compliant billing and collection activities
- Manage- billing and follow up staff to ensure timely and compliant billing and collection of all revenue associated with government and non-government payers.
CARE REPRESENTATIVE
SITEL
03.2012 - 01.2014
- Facilitate retail sales of cellular phones and wireless services and products to the general public while demonstrating outstanding customer service
- Create additional sales opportunities through creative marketing campaigns and community involvement
- Develop continuous and up-to-date knowledge of Verizon Wireless and wireless products and services; demonstrate equipment capabilities
- Multi-tasking through screens to process customer request or insurance claims, assisting members with accounts and billing questions, processing payments and shipment orders, and assisting with basic trouble shooting.
Education
Associate of Applied Science - Radiation Protection
Aiken Technical College
Graniteville, SC08-2024
Phlebotomy - Medical Assisting
Virginia college
Augusta, GA01.2016
Skills
- Data Entry
- Excellent Written and Verbal Communication
- Teamwork
- Problem Solving
- Leadership
- Continuous Learning
- Adaptability
- Self-management
- Administrative Skills
- Customer Care / Customer Support Service
- Strong analytical and reasoning skills
- Microsoft Office
- Salesforce
- Genesis
- Time Management
- Interpersonal Communication
- Insurance Claims Review
- Data Analysis
- Coverage Determination
- Database Management
- Flexible Schedule
- Coverage assessments
- Allocating claims
- Policy Knowledge
- Documentation research
- Managing recruitment
- Improving performance
- Call handling
- Expense Tracking
- Document Preparations
chat support
Technically support
- CRM Software
- Quality Control
- Customer Service
- Direct Sales
- Retail Marketing
- Call Metrics
- MS Office
- Microsoft Office expertise
Timeline
CLRU Claim's Representative
Progressive Casualty Insurance
06.2022 - Current
Claims specialist
Sedgwick
11.2020 - 01.2021
Administrative Assistant (Temp)
Ntt data
08.2019 - 11.2019
billing specialist
Capture NET
01.2019 - 06.2019
Benefit Enrollment Specialist
TELEPERFORMANCE
10.2016 - 05.2021
CARE REPRESENTATIVE
SITEL
03.2012 - 01.2014
Associate of Applied Science - Radiation Protection
Aiken Technical College
Phlebotomy - Medical Assisting
Virginia college