Lynnette Hobbs
Claims/Appeals Specialist
Columbus,United States
Summary
Experienced Supplemental Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 15 years of experience and willingness to take on any challenge.
Overview
29
29
years of professional experience
Work History
Customer Service Representative
Global Payments
03.2022 - Current
- Responds to customer inquiries via telephone, email, SMS and Chat to provide problem resolution in accordance with the organization's service standards
- Receives and/or places telephone calls which are predominantly routine, but may require deviation from standard screens, scripts, and procedures
- Answer customer telephone inquiries, orders, service needs and complaints, respond where applicable or direct to technical/service areas
- Maintain detailed and current knowledge of the company's/assigned client's products and services
- Analyze customer service needs for communication to service and technical departments, when applicable
- Requires ability to navigate a computerized data entry system or other relevant applications.
Claims Appeal Specialist
Aflac
06.2019 - 12.2020
- Services customers by determining insurance coverage; examining and resolving claims; documenting actions; maintaining quality customer services; ensuring legal compliance
- Determines covered medical insurance losses by studying provisions of policy or certificate
- Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, as needed; initiating or conducting investigation of questionable claims
- Documents medical claims actions by completing forms, reports, logs, and records
- Provide reinforcements to customer service and claims specialist
- Review and approve claims appeal
- Assisting co workers as needed
- Escalate situations as necessary
Hospital/Intensive Care Claims Specialist
Aflac
01.2014 - 06.2019
- Services customers by determining insurance coverage; examining and resolving claims; documenting actions; maintaining quality customer services; ensuring legal compliance
- Determines covered medical insurance losses by studying provisions of policy or certificate
- Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, as needed; initiating or conducting investigation of questionable claims
- Documents medical claims actions by completing forms, reports, logs, and records.
Cancer/Disability Claims Specialist
Aflac
01.2008 - 06.2014
- Services customers by determining insurance coverage; examining and resolving claims; documenting actions; maintaining quality customer services; ensuring legal compliance
- Determines covered medical insurance losses by studying provisions of policy or certificate
- Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, as needed; initiating or conducting investigation of questionable claims
- Documents medical claims actions by completing forms, reports, logs, and records.
Cancer Claims Specialist
Aflac
01.2005 - 03.2008
- Services customers by determining insurance coverage; examining and resolving claims; documenting actions; maintaining quality customer services; ensuring legal compliance
- Determines covered medical insurance losses by studying provisions of policy or certificate
- Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, as needed; initiating or conducting investigation of questionable claims
- Documents medical claims actions by completing forms, logs, and records.
Residential Counselor
Robert F. Kennedy Children’s Action
01.2004 - 01.2005
- As part of a team of Professionals providing supervision and support to emotionally challenged, court-involved youth as well as leading them through daily life space and recreational activities.
Customer Service Representative
First Notice Systems
01.2001 - 01.2003
- Highly skilled customer service representative trained in sensitive insurance programs to expertly guide callers through time of need
- Answer all service calls in an inbound call center and log them as appropriate into the computer system
- Explaining all benefits, services and claim/reimbursement procedures while processing customer transactions
- Assisting representatives with questions and procedures/providing internal customer service as well as Interfacing with customers, clients, and vendors and escalate areas of concern to the appropriate supervisory staff
Administrative and Clerical Support
Advantage Staffing
01.1998 - 01.2001
- Administrative support that included filing, phones, correspondence and data entry, accounts payable and billing.
Mail Handler
United States Postal Service
01.1997 - 01.1998
- Hand sorting items by zip code for delivery.
Payroll Assistant
C&S Wholesale Distributions
01.1995 - 01.1998
- Extensive data entry
- Typing correspondences
- Generating computerized reports
- Distribution of payroll checks
- Recording and transcribing meeting minutes and tracking of attendance
Clerical and Medical Billing Associate
United Personnel
01.1994 - 01.1995
- Various clerical, data entry and medical billing positions
Education
Lean Six Sigma Yellow Belt -
RIVERWOOD ASSOCIATES
Associate of Applied Science - Cybersecurity
Columbus Technical College
Columbus, GA05.2022
Associate of Applied Science - Technical Studies
Columbus Technical College
Columbus Ga05.2022
Associate of Applied Science - Management and Supervisory Development
Columbus Technical College
Columbus, GA12.2010
Associate of Applied Science - Business studies
Columbus Technical College
Columbus, GA09.2009
Certificate - Office Technology
Porter And Chester Institute - Enfield
Enfield, CT05.1995
Accounting, Advanced Word Processing, General Clerical - undefined
MASSACHUSETTS CAREER DEVELOPMENT INSTITUTE
1988
Skills
- Administrative and Office Support
- Accurate Recordkeeping
- Microsoft Office
- Client Rapport-Building
- Appeals Support
- Call Control
- Customer Service Process Improvement
- Claims Adjustments
- Policy and Procedure Explanations
- Secure Data Practices
- Documentation Review
- Claims
Timeline
Customer Service Representative
Global Payments
03.2022 - Current
Claims Appeal Specialist
Aflac
06.2019 - 12.2020
Hospital/Intensive Care Claims Specialist
Aflac
01.2014 - 06.2019
Cancer/Disability Claims Specialist
Aflac
01.2008 - 06.2014
Cancer Claims Specialist
Aflac
01.2005 - 03.2008
Residential Counselor
Robert F. Kennedy Children’s Action
01.2004 - 01.2005
Customer Service Representative
First Notice Systems
01.2001 - 01.2003
Administrative and Clerical Support
Advantage Staffing
01.1998 - 01.2001
Mail Handler
United States Postal Service
01.1997 - 01.1998
Payroll Assistant
C&S Wholesale Distributions
01.1995 - 01.1998
Clerical and Medical Billing Associate
United Personnel
01.1994 - 01.1995
Lean Six Sigma Yellow Belt -
RIVERWOOD ASSOCIATES
Associate of Applied Science - Cybersecurity
Columbus Technical College
Associate of Applied Science - Technical Studies
Columbus Technical College
Associate of Applied Science - Management and Supervisory Development
Columbus Technical College
Associate of Applied Science - Business studies
Columbus Technical College
Certificate - Office Technology
Porter And Chester Institute - Enfield
Accounting, Advanced Word Processing, General Clerical - undefined
MASSACHUSETTS CAREER DEVELOPMENT INSTITUTE
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