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
Columbus GA
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
Columbus GA
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
Columbus GA
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
Columbus, Ga
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
Springfield MA
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