Monica Coyman
Portsmouth,New Hampshire
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes, with superior Customer Service focus within the same organization.
Overview
13
13
years of professional experience
Work History
Claims Auditor
EBPA
Exeter, NH
11.2017 - Current
- Researched issues related to claims processing to identify origins and implement corrective solutions.
- Prioritized daily tasks to satisfy workload demands and department's turnaround goals.
- Researched claims and incident information to deliver solutions and resolve problems.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Used Javelina, Luminex systems to program, set up functions, and enter data for medical and dental claims for testing and processing of all levels of claims.
Customer Service Representative
EBPA
Exeter, NH
07.2012 - 11.2017
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered 60 + customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Handle medica, dental, vision, flex spending, STD and COBRA inquires.
- Review and make resolutions regarding benefits and claim processing for medical, dental, STD and vision services, flex spending accounts ( medical, dental, vision, dependent care, tuition, transit and parking)
Education
High School Diploma -
Billerica Memorial High School
Billerica, MASkills
- Case Presentations
- Departmental Operations
- Client Interviewing
- Legal Documentation
- Accounts Payable and Accounts Receivable
- Effective Customer Communication
- Customer Satisfaction
- Claims Evaluations
- Billing Cycle Performance
- Complex Problem-Solving
- Time Management
- Billing Procedures
- Corrective Actions
- Special Projects
- Superior Customer Service
- Claims Investigation and Research
Timeline
Claims Auditor
EBPA
11.2017 - Current
Customer Service Representative
EBPA
07.2012 - 11.2017
High School Diploma -
Billerica Memorial High School
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