Summary
Overview
Work History
Education
Skills
Timeline
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LaTessa Jones

Summary

Skilled processing professional with extensive experience in reviewing and validating claims. Strong focus on accuracy, problem-solving, and effective communication. Known for collaborative approach and adaptability to changing needs. Proficient in claims software, data entry, and customer service. Recognized for reliability and achieving results in team environments.

Overview

12
12
years of professional experience

Work History

CLAIMS PROCESSOR

Swbc Mortgage
03.2022 - 08.2024
  • Analyzed customer documentation for accuracy and completeness before processing claims
  • Verified insurance coverage by reviewing policies, endorsements, and other documents
  • Demonstrated strong communication skills while interacting with both internal staff and external customers
  • Requested information from internal or external sources to complete and validate claims
  • Maintained detailed records of all claims processed, ensuring accuracy and completeness
  • Interpreted complex policy language to determine coverage limits and exclusions
  • Performed data entry to update database with new claim information
  • Assessed eligibility criteria of customers in accordance with company guidelines
  • Researched and resolved discrepancies between the insurer's system and customer records
  • Updated insurance policies for changes, reinstatements and cancellations
  • Conducted quality assurance reviews of completed claims prior to submission
  • Communicated with insurers to resolve issues related to denied or delayed payments
  • Communicated with claimants to answer questions regarding claim status and processes
  • Recorded and maintained insurance policy and claims information in database systems
  • Interviewed clients and took calls to provide customer service and obtain information on claims
  • Modified and processed existing policies and claims to reflect change in beneficiary, amount of coverage, or type of insurance

INSURANCE VERIFICATION SPECIALIST

Allstate Insurance Co
02.2021 - 03.2022
  • Provided exceptional service through timely follow-ups with clients, keeping them informed throughout the claims process.
  • Educated clients on available auto insurance products, empowering them to make informed decisions regarding their coverage options.
  • Developed strong relationships with clients, fostering trust and loyalty while promoting long-term business growth.
  • Worked closely with claims adjusters to expedite claim resolutions, ensuring timely payouts for clients experiencing loss or damage events.
  • Facilitated smooth policy renewals by proactively identifying and addressing potential issues before they escalated, ensuring client satisfaction.
  • Ensured accurate policy administration by diligently reviewing and updating client information, reducing errors in coverage.
  • Collaborated with underwriters to ensure accurate risk evaluation, optimizing premium rates for both company profitability and client affordability.
  • Increased customer satisfaction by providing personalized auto insurance solutions tailored to individual needs.
  • Conducted thorough needs assessments, recommending suitable coverage options based on each client''s unique situation.

HUMAN RESOURCES ADMINISTRATOR

TTEC
01.2020 - 02.2021
  • Managed all human resource documentation, including new hire letters, employee contracts and corporate policies and procedures
  • Supervised onboarding process for newly hired employees, including distribution of all paperwork
  • Supervised exit interviews and off-boarding process for resigned and terminated employees
  • Supported top talent identification processes by interviewing candidates and executing onboarding, orientation and benefits processes
  • Leveraged internal HR databases to organize and maintain personnel records, enter employee data and update previous data
  • Answered employee questions regarding health benefits and401k options
  • Oversaw benefits enrollment process by answering questions and assisting employees with login details

CUSTOMER SERVICE REPRESENTATIVE

KindHealth
08.2019 - 01.2020
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
  • Remained calm and professional in stressful circumstances and effectively diffused tense situations
  • Demonstrated excellent communication skills in resolving product and consumer complaints
  • Assisted customers with making payments or establishing payment plans to bring accounts current
  • Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.

TECHNICAL SUPPORT SPECIALIST

Charter Communications Inc
04.2018 - 08.2019
  • Received inbound phone calls from customers to provide first-level support and remotely troubleshoot issues with service, equipment or customer accounts
  • Disassembled computer systems to troubleshoot and resolve hardware issues
  • Communicated with customers to identify issues, walk through solutions and initiate corrective actions to restore service and functionality
  • Consulted via telephone to understand user problems, run through testing scripts and ask probing questions to locate root causes
  • Documented repair processes and helped streamline procedures for future technical support actions

LICENSED INSURANCE AGENT

TeleTech
11.2016 - 04.2018
  • Upsold products to policyholders and potential new clients
  • Exceeded company sales goals for new policies
  • Engaged customers and provided high level of service by carefully explaining details about documents
  • Analyzed customer needs and provided best options, upselling products and services
  • Obtained underwriting approval by completing application for coverage
  • Determine clients' particular needs and financial situations by scheduling fact-finding appointments and determining the extent of present coverage and investments

Boatswain's Mate

US Navy
06.2012 - 11.2016
  • Operated and maintained equipment used in loading and unloading cargo, ammunition, fuel and general stores
  • Conducted, searched, and rescued operations and also respond to other military and civilian ships that request assistance
  • Lead LSE (landing signalmen enlisted), guiding helicopter to a designated flight deck of a ship on air capable ships
  • Operated large marine vessels by adjusting speed, steering craft and utilizing navigation instruments.
  • Kept watch aboard vessels to identify changing conditions or potential issues and implement corrective actions.
  • Utilized navigation expertise and tools to set courses and determine ship position throughout travel.
  • Adhered to laws and regulations based on voyage locations.
  • Docked and undocked vessel using radios, depth finders, radars, lights, lighthouses and buoys to make safe and accurate operational decisions.
  • Loaded cargo according to ship capacity and appropriate weight load distribution.
  • Took responsibility for ship operations in cases of injury or illness.
  • Protected ship and personnel by signaling passing vessels with flashing lights, flags, radios and whistles.

Education

Bachelor of Science - Cyber Security

Western Governors University
Salt Lake City, UT

High School Diploma -

Belton High School
Belton, TX
06-2011

Skills

  • ICD-10
  • Benefits Administration
  • Financial services
  • Live chat
  • Customer Service (10yrs)
  • Quality assurance
  • Medical Terminology
  • Microsoft Expertise
  • ADP
  • Payroll
  • Data Entry
  • Quickbooks
  • Upsell/Sales
  • Inbound/Outbound Calling
  • Technical Support
  • Windows/Chrome
  • Zoom/Skype/Teams
  • Insurance Specialist
  • Decision-Making
  • Problem-Solving
  • Recordkeeping and documentation
  • Payment plan processing
  • Basic accounting principles
  • Account discrepancies
  • Client confidentiality
  • Payment processing
  • Audits
  • Excellent negotiation skills
  • Spreadsheet proficiency
  • Software applications

Timeline

CLAIMS PROCESSOR

Swbc Mortgage
03.2022 - 08.2024

INSURANCE VERIFICATION SPECIALIST

Allstate Insurance Co
02.2021 - 03.2022

HUMAN RESOURCES ADMINISTRATOR

TTEC
01.2020 - 02.2021

CUSTOMER SERVICE REPRESENTATIVE

KindHealth
08.2019 - 01.2020

TECHNICAL SUPPORT SPECIALIST

Charter Communications Inc
04.2018 - 08.2019

LICENSED INSURANCE AGENT

TeleTech
11.2016 - 04.2018

Boatswain's Mate

US Navy
06.2012 - 11.2016

Bachelor of Science - Cyber Security

Western Governors University

High School Diploma -

Belton High School

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LaTessa Jones