Markisha Curtis
Columbus
Summary
Dynamic Claims Specialist, skilled in fraud detection and conflict resolution. Proven track record in enhancing customer service standards and streamlining claims processes. Bilingual in English and Spanish, I excel in virtual case management and effective communication, ensuring compliance and delivering exceptional support to clients.
Overview
12
12
years of professional experience
Work History
Insurance Claims Specialist
Nationwide
Columbus
08.2022 - 12.2025
- Underwrote life insurance claims up to $1M by conducting reviews, research, and interpreting records/paperwork to make accurate claim decisions.
- Evaluated insurance claims for completeness and compliance with company policies.
- Collaborated with clients to gather necessary documentation and information.
- Communicated claim decisions to clients via phone and written correspondence.
- Investigated discrepancies in claims by consulting with relevant stakeholders.
- Assisted in training new staff on claims processing procedures and best practices.
- Resolved client inquiries regarding claims status and provided updates promptly.
- Calculated benefit payments based on policy terms, coverage limits, and applicable regulations.
- Assisted customers in filing new insurance claims and provided status updates on existing ones.
- Maintained detailed records of all claim activities including correspondence, decisions, payments.
- Reviewed denied claims for errors or omissions before finalizing decision notices.
- Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims.
- Resolved customer complaints related to insurance claim processing.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Developed strategies for improving customer service standards within the department.
- Investigated suspicious or fraudulent claims and reported findings to management.
- Coordinated with external parties such as lawyers, surveyors, appraisers during investigations.
- Ensured compliance with state laws governing insurance practices as well as company policies and procedures.
- Processed requests for additional documentation from customers in a timely manner.
- Precisely calculated refunds, premiums, and adjustments.
- Provided bilingual support internally and externally for Spanish-speaking customers.
Bilingual Rep, Internal Sales and Service
Nationwide
Columbus
10.2019 - 08.2022
- Provided bilingual (English/Spanish) quality sales & service support to financial advisors, agents, and customers through annuity product education, cross-marketing, first and final resolution, fraud detection and prevention, and interpretation of regulatory changes and FINRA compliance requirements.
- Processed phone withdrawals for eligible contract holders.
- Collaborated with leadership in LEAN problem-solving initiatives to streamline customer experience.
Referral Coordinator II
Humana Government Business
10.2017 - 01.2019
- Processed medical referrals from Military Treatment Facilities (MTFs) and civilian providers by assigning appropriate care providers, reviewing benefits and/or medical necessity, and requesting follow-up for additional nurse case management, while adhering to TRICARE benefit guidelines, Humana Military policies and procedures, as well as U.S. Department of Defense confidentiality.
JFS Specialist
Ohio Department of Job and Family Services
07.2015 - 07.2016
- Determined eligibility for Public Assistance programs.
- Researched local, state, and federal public records and databases to verify and obtain diverse economic, residential, employment, health, resource assets, and education demographics for accurate benefit calculation and effective ongoing case management.
- Conducted timely and resolute oral, written, and telephonic correspondence with clients, client-authorized third party representatives, County Administration, local, state, and federal agencies as warranted.
Economic Support Specialist
Ohio Department of Job and Family Services
12.2013 - 07.2015
- Performed as Receptionist of Montgomery County JFS Investigation and Recovery Unit.
- Managed Montgomery County JFS Tax Offset and Fraud Report Hotlines.
- Conducted employment investigations for undisclosed employment income.
- Received and constructed public assistance fraud reports for Investigators.
- Provided comprehensive case resolution services to customers in the Montgomery County JFS Telecommunications Center.
- Mentored new-hires with job execution and agency integration strategies.
Education
B.A. - Social and Behavioral Sciences, Criminology
The Ohio State University
Columbus, OH01.2005
Skills
- Spanish language fluency
- Remote and direct customer service
- Conflict resolution
- Effective communication
- Fraud detection and prevention
- Virtual case management
- Brand marketing
- Workshop facilitation
- Office administration
- Business applications
- Telecommunication services
- Claims investigation and evaluation
- Customer relationship management
- Process improvement
Hobbies and Interests
- Travel
- Photography
- Horseback Riding
- Outdoor Exploration
- Writing
- Community Engagement
Languages
English
Native/ Bilingual
Spanish
Professional
Accomplishments
Associate of the Quarter, Q3 2025
Affiliations
Member/Volunteer, Community Impact Committee of Nationwide's Women Empowered Associate Resource Group
Timeline
Insurance Claims Specialist
Nationwide
08.2022 - 12.2025
Bilingual Rep, Internal Sales and Service
Nationwide
10.2019 - 08.2022
Referral Coordinator II
Humana Government Business
10.2017 - 01.2019
JFS Specialist
Ohio Department of Job and Family Services
07.2015 - 07.2016
Economic Support Specialist
Ohio Department of Job and Family Services
12.2013 - 07.2015
B.A. - Social and Behavioral Sciences, Criminology
The Ohio State University