Marie Gramm
Tucson,AZ
Summary
Experienced Claims Representative with background in insurance, healthcare, and customer service. Strengths include strong analytical skills, ability to handle multiple tasks efficiently, and exceptional communication abilities. Previous work has involved investigating insurance claims, providing benefits and eligibility, negotiating settlements, and providing superior service to policyholders. Have consistently improved efficiency and reduced claim processing timeframes in past roles.
Overview
8
8
years of professional experience
Work History
Claims Representative
Teleperformance USA
Tucson, AZ
08.2021 - Current
- Processed insurance claims efficiently and accurately for diverse clients.
- Communicated with customers to gather necessary claim information and documentation.
- Reviewed claim files to ensure compliance with company policies and regulations.
- Utilized claims management software to track and update claim statuses promptly.
- Provided exceptional customer service by addressing concerns and answering questions.
- Assisted in training new representatives on claims procedures and best practices.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
Provider Services Supervisor
C3 Customer Contact Channels
Tucson, AZ
08.2017 - 07.2021
- Supervised provider services team to ensure compliance with company standards.
- Coordinated training sessions for new staff on service protocols and systems.
- Managed scheduling and workflow to optimize team productivity and efficiency.
- Conducted performance evaluations to support employee development initiatives.
- Resolved provider inquiries and concerns to maintain strong relationships.
- Maintained accurate records of all transactions related to provider services operations.
- Assisted providers in resolving claims issues, including researching and responding to inquiries.
- Resolved escalated customer complaints from providers in a timely manner.
- Monitored departmental activities to ensure timely completion of tasks within established deadlines.
- Tracked progress against goals set by management for the Provider Services Department.
- Participated in meetings with external vendors concerning provider relations initiatives.
Education
Some College (No Degree) - Accounting And Finance
Jefferson Davis Community College
Biloxi, MSSkills
- Claims processing
- Regulatory compliance
- Claims management software
- Customer service
- Data analysis
- Team supervision
- Employee training
- Performance evaluation
- Problem resolution
- Time management
- Interpersonal communication
- Conflict resolution
- Allocating claims
- Microsoft office
- Insurance claims review
- Claims investigation
- Insurance regulations
- Coverage determination
- Documentation
- Verbal and written communication
- Data entry
- Insurance terminology
Timeline
Claims Representative
Teleperformance USA
08.2021 - Current
Provider Services Supervisor
C3 Customer Contact Channels
08.2017 - 07.2021
Some College (No Degree) - Accounting And Finance
Jefferson Davis Community College