Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Marcas Mcconnell

Kansas City,KS

Summary

Dynamic customer service leader with extensive experience at GEHA, excelling in claims processing and conflict resolution. Proven track record of enhancing team performance and driving improvements through data analysis. Skilled in managing high-volume claims while ensuring compliance and delivering exceptional service. Adept at problem-solving and fostering positive customer relationships.

Overview

20
20
years of professional experience

Work History

Customer Service Lead

GEHA
Lees Summit, MO
07.2019 - 12.2024
  • Monitored team performance against set targets and KPIs.
  • Resolved escalated issues from team members or customers in an efficient manner.
  • Reviewed customer feedbacks to identify areas for improvement in products and services.
  • Analyzed customer data to provide insights on trends, preferences and needs.
  • Maintained accurate records of customer interactions and transactions.
  • Generated reports on key metrics such as average response time, first call resolution rate.
  • Participated in regular meetings with senior management team to discuss progress of projects and initiatives related to customer service operations.
  • Handled customer inquiries and complaints in a professional manner.

Claims Representative

GEHA
Lee's Summit, MO
10.2010 - 07.2019
  • Conducted research into medical terminology related to healthcare claims processing activities.
  • Handled customer inquiries regarding insurance policy coverage details and payment status updates.
  • Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
  • Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
  • Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
  • Processed a high volume of claims efficiently while maintaining quality standards.
  • Documented changes in claim statuses using specialized software systems.
  • Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
  • Ensured timely submission of required documentation from claimants prior to approval of payment.
  • Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
  • Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.

Benefits Administrator

The Hartford
Overland Park, KS
05.2005 - 06.2010
  • reviewed and analyzed Worker's comp claims to determine eligibility for benefits.
  • investigated and gathered necessary information such as medical records and witness statements to determine validity of claims.
  • Managed caseload of 20 claims simultaneously while insuring processing and adherence to regulatory requirements.
  • determined appropriate benefit amounts based on severity of injury.

Education

Business Administration

Kansas City Kansas Community College
Kansas City, KS

Skills

  • Customer service
  • Team leadership
  • Claims processing
  • Insurance knowledge
  • Conflict resolution
  • Problem solving
  • Time management
  • Payment processing

References

References available upon request.

Timeline

Customer Service Lead

GEHA
07.2019 - 12.2024

Claims Representative

GEHA
10.2010 - 07.2019

Benefits Administrator

The Hartford
05.2005 - 06.2010

Business Administration

Kansas City Kansas Community College

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