Summary
Overview
Work History
Education
Skills
Timeline
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Makaylia Dunn

Fayetteville,GA

Summary

Organized Insurance Claims professional offering expertise in investigation, litigation and settlements. Proficient in executing claims transactions and applying settlement protocols to foster timely, fair and accurate claims processing. Track record of superior performance in tea, leadership roles.

Overview

8
8
years of professional experience

Work History

Remote Claims Examiner

Cigna
Atlanta, GA
11.2021 - 09.2024
  • Managed workloads efficiently by prioritizing tasks based on urgency or importance.
  • Reviewed invoices for accuracy before submitting them for payment.
  • Maintained up-to-date knowledge about changes in healthcare reform legislation affecting provider reimbursements.
  • Reviewed and resolved open claims and change orders to determine entitlement for additional payment.

Claims Adjuster

Progressive
Newnan, Georgia
03.2018 - 05.2020
  • Determined reserves for each claim based on estimated costs of settlement or defense.
  • Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
  • Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
  • Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.

Healthcare Customer Service Representative

CareCentrix
Atlanta, Georgia
08.2016 - 03.2018
  • Scheduled appointments for patients using the electronic health records system.
  • Generated monthly performance metrics reports based on customer feedback survey results.
  • Adhered to HIPAA regulations when handling confidential patient information.
  • Assisted in checking patient's insurance eligibility prior to their appointment.
  • Responded promptly to emails, voicemails, and faxes from customers seeking assistance or advice.

Education

High School Diploma -

Southern Guilford High School
Greensboro, NC
06-2016

Some College (No Degree) - Business Management

Southern Crescent Technical College
Griffin, GA

Skills

  • Fair Isaac claims advisor
  • Investigative skills
  • Coverage analysis
  • Data verification
  • Policy Interpretation
  • Automated work distributor (AWD)
  • Customer service and support
  • Attention to detail

Timeline

Remote Claims Examiner

Cigna
11.2021 - 09.2024

Claims Adjuster

Progressive
03.2018 - 05.2020

Healthcare Customer Service Representative

CareCentrix
08.2016 - 03.2018

High School Diploma -

Southern Guilford High School

Some College (No Degree) - Business Management

Southern Crescent Technical College

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Makaylia Dunn