Nicole Bowman
Riverview,FL
Summary
Results-driven Medical Claims Representative known for high productivity and efficient task completion. Specialize in claims processing, policy interpretation, and dispute resolution, ensuring accuracy and compliance with industry standards. Excel in communication, problem-solving, and negotiation, contributing to streamlined operations and customer satisfaction.
Overview
18
18
years of professional experience
Work History
Medical Claim Representative
Progressive Insurance Companies
Riverview, FL
07.2024 - Current
- Ensured accuracy and compliance of medical claims with company policies through thorough analysis.
- Communicated with policyholders to obtain essential documentation for claim processing.
- Utilized claims management software to efficiently track and manage workflows.
- Investigated billing discrepancies in codes and patient information related to claims.
- Conducted quality assurance reviews of insurance claims prior to payment approval.
- Documented all claims decisions per established guidelines.
- Verified liability by reviewing police reports and medical treatment histories.
Customer Service/ Sales Supervisor
Verizon Wireless
Tampa, Florida
07.2019 - 10.2023
- Managed and trained a rotating team of 20 individuals, in a fast paced dynamic environment to ensure excellent customer service and sales.
- Collaborated with cross-functional teams to drive sales, build customer relations, and drive performance results.
- Conducted 30+ sales calls daily to introduce products and services to potential customers.
- Identified opportunities for upselling and cross-selling additional products and services, exceeding sales targets by an average of 50% annually.
- Delivered consultative sales support by identifying areas within the customer service process conducive to upselling and cross-selling, enhancing revenue generation and fostering client satisfaction.
Senior Customer Service Coordinator
Verizon Wireless
Tampa, Florida
09.2014 - 07.2019
- Researched and executed innovative strategies to effectively address customers' needs and enhance satisfaction levels.
- Proficiently deescalated conflicts and skillfully negotiated contracts with customers to secure mutually beneficial agreements.
- Achieved and sustained 95% customer satisfaction through diligent service and proactive problem-solving whiles increasing sales annually.
- Facilitated timely communication between customers, management, sales teams, external vendors., as needed.
- Oversaw and guided a rotational team of 20 to handle customer call escalations, order processing, and sales.
Customer Service Attendant
Busch Gardens
Tampa, FL
11.2007 - 01.2012
- Assist customers by delivering comprehensive information and addressing complaints promptly and effectively to ensure satisfaction.
- Process customer payments accurately and efficiently, utilizing payment systems and ensuring compliance with financial procedures.
- Demonstrate communication and interpersonal abilities.
- Thrived in a fast-paced work environment.
- Manage multiple tasks with efficiency and precision.
Education
Certification - Paralegal Studies
Hillsborough Community College
Tampa, FL05-2014
Bachelor of Arts - Political Science
University of South Florida
Tampa, FL05-2013
Skills
- Critical decision-making and confidence
- Sales analytics and data analysis
- Customer experience enhancement
- Conflict resolution and tactfulness
- Cold-calling and consultative sales
- Claims management and processing
- Quality assurance and policy interpretation
- Medical record review and investigations
Timeline
Medical Claim Representative
Progressive Insurance Companies
07.2024 - Current
Customer Service/ Sales Supervisor
Verizon Wireless
07.2019 - 10.2023
Senior Customer Service Coordinator
Verizon Wireless
09.2014 - 07.2019
Customer Service Attendant
Busch Gardens
11.2007 - 01.2012
Certification - Paralegal Studies
Hillsborough Community College
Bachelor of Arts - Political Science
University of South Florida