Makayla Louden
Ozark,MO
Summary
Seeking a Remote role with 9 years of customer service experience, including claims handling, healthcare support, and call center operations. Proficient in data entry, appointment scheduling, and issue resolution; adept at maintaining high customer satisfaction. Demonstrates strong multitasking and communication skills in remote office settings.
Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in insurance policies, practices and standards.
Overview
4
4
years of professional experience
Work History
Claims Representative
Oscar Health Insurance
03.2023 - 10.2024
- Analyze claim data and interpret policy language to ensure claim resolutions align with company standards
- Assist customers with claims paperwork and guide them through evidence submission process
- Maintain meticulous records for policyholders, including documentation for policy reinstatements and cancellations
- Assess property damage and produce accurate damage estimates for claim processing
- Developed in-depth understanding of insurance policies and procedures.
- Investigated and resolved complex claims, ensuring adherence to policy guidelines and regulatory compliance.
- Developed strong relationships with clients, facilitating trust and open communication during claims process.
- Conducted detailed investigations into suspicious claims, reducing instances of fraud.
HealthCare Customer Service Representative
Alorica
07.2021 - 03.2023
- Scheduled patient appointments utilizing an electronic health records system, ensuring efficient and accurate scheduling practices
- Updated and maintained patient files in strict adherence to company policy and procedural guidelines
- Processed various medical claims paperwork, including authorizations, referrals, and pre-certifications, contributing to the seamless operation of the claims process
- Verified and corrected patient demographic information to maintain high standards of data accuracy, and prepared reports on patient visits for management as required
Call Center Representative
Verizon Wireless
06.2020 - 06.2021
- Addressed customer inquiries and resolved concerns effectively, ensuring high levels of satisfaction and providing thorough support for issues related to billing, shipping, and warranties
- Delivered informational updates to clients about new products, services, and company policies, enhancing customer engagement and knowledge
- Participated in team efforts to refine customer service protocols, contributing to improved performance metrics including call resolution rates and average handle times
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
- Established trust with clients by accurately addressing their concerns and offering appropriate resolutions based on their needs.
Education
Associate Degree - General Studies
Louisiana Delta Community College
Monroe, LA05.2021
High School Diploma - High School Education
Forest High School
Forest, LA05.2021
Skills
- Medical Terminology
- Inbound and Outbound Calling
- Data Entry
- Appointment Scheduling
- Call Center Operation
- Critical Thinking
- Phone Etiquette
- Billing Management
- Issue and Complaint Resolution
- Policies and Procedures Adherence
- Understanding Customer Needs
- Professional Telephone Demeanor
- Remote Office Availability
- Multitasking
- Account Updating
- Customer Service
Timeline
Claims Representative
Oscar Health Insurance
03.2023 - 10.2024
HealthCare Customer Service Representative
Alorica
07.2021 - 03.2023
Call Center Representative
Verizon Wireless
06.2020 - 06.2021
High School Diploma - High School Education
Forest High School
Associate Degree - General Studies
Louisiana Delta Community College
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