Michelle Waiters
Hampton,Virginia
Summary
Ensured delivery of consistent, high-quality member service while surpassing key performance indicators across multiple metrics.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
Calculated Hire
Remote
09.2025 - Current
- Provide exceptional inbound customer and technical support, resolving issues for an average of 40+ customers daily.
- Set expectations for turnaround times.
- Collaborate with internal teams.
Claims Examiner
Hays U.S.
Remote
06.2024 - 12.2024
- Evaluated and resolved travel and medical benefit claims by reviewing prior authorization requests, contracts, and insurance policies.
- Determined coverage eligibility and issued payments or denials in compliance with insuring agreements.
- Adhered to confidentiality and discretionary principles in accordance with HIPAA guidelines.
- Promoted to Oversight Department for audit responsibilities due to consistent high-quality performance.
- Audited resolved claims to ensure full compliance with internal and external guidelines.
Claims Adjuster
USAA
Chesapeake, Virginia
01.2020 - 01.2024
- Successfully managed and evaluated property claims from FNOL to resolution.
- Investigated liability, reviewed coverage, and analyzed damages to prepare fair settlement payments.
- Delivered consistent, high-quality member service and exceeded KPIs by 20% across multiple metrics.
- Drafted settlement letters, RORs, and denial communications in accordance with compliance protocols.
- Scoped and estimated damages using Xactimate Software.
Travel Specialist and Lifestyle Concierge
Aspire Lifestyles
Remote
01.2016 - 01.2020
- Delivered tailored travel and concierge solutions to high-value clients using strong communication and coordination skills.
- Collaborated with vendors and internal teams to fulfill requests and resolve issues promptly.
Education
Bachelor of Science - Criminal Justice
Old Dominion University
Norfolk, VirginiaSkills
- Delivered exceptional customer service by addressing inquiries and resolving issues promptly
- Active listening
- Critical thinking
- Data entry
- Microsoft Office Suite
- Call management
- Employee coaching and mentoring
- Problem-solving
- Multitasking Abilities
- Effective communication
- Adaptability and flexibility
- CRM software proficiency
Timeline
Customer Service Representative
Calculated Hire
09.2025 - Current
Claims Examiner
Hays U.S.
06.2024 - 12.2024
Claims Adjuster
USAA
01.2020 - 01.2024
Travel Specialist and Lifestyle Concierge
Aspire Lifestyles
01.2016 - 01.2020
Bachelor of Science - Criminal Justice
Old Dominion University