Paris Johnson
Atlanta,GA
Summary
Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Hardworking and passionate job seeker with strong organizational skills eager to secure an entry-level position. Ready to help team achieve company goals. Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options. Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results. Professional Call Center Customer Service Representative committed to providing courteous, prompt, detailed and accurate support. Experience managing outbound and inbound calls and handling emergency issues with patience and tact. Experienced Customer Service Representative with 6 years of experience working in busy, fast-paced call center. Committed to providing prompt, quick and accurate service to large volume of incoming calls.
Overview
6
6
years of professional experience
Work History
Insurance Claims Adjuster
Loya Insurance
02.2022 - 03.2023
- Evaluated insurance policies and analyzed damages to determine coverage.
- Prepared summaries of damage, payments, and policy coverage.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Answered customer questions regarding deductibles.
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Substantiated legitimate claims and denied unjustified claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Call Center Agent
Wipro, Remote
11.2021 - 05.2022
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Responded to customer calls and emails to answer questions about products and services.
- Analyzed and escalated complaints, issues and grievances to designated departments for investigation and response.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Addressed customer account discrepancies and concerns.
- Received multiple positive reviews acknowledging dedication to excellent customer service.
- Verified accurate responses to questions and inquiries by maintaining advanced product knowledge.
Phlebotomist
Piedmont Hospital
04.2020 - 09.2021
- Labeled transfer tubes and followed exact directions for handling and storing specimens for transport.
- Completed proper sanitation and cleaning of equipment and work areas between patients.
- Centrifuged blood samples as outlined in clinical protocols.
- Established and maintained positive working relationships with patients, staff and clinical personnel to build trust and camaraderie.
- Used personal protective equipment correctly to protect coworkers and patients.
- Tracked collected specimens by initialing, dating, and noting times of collection.
- Monitored patients for reactions and verified sample quality.
- Reviewed patient records for accuracy and completeness.
Medical Claims Specialist
LabCorp
05.2018 - 04.2020
- Submitted electronic/paper claims documentation for timely filing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Identified and resolved discrepancies between patient information and claims data.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Monitored and updated claims status in claims processing system.
Claims Specialist
Automation Staffing
01.2018 - 05.2018
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Conducted full claim investigations and reported updates and legal actions.
Customer Service Representative
Walmart
09.2016 - 01.2018
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Processed customer service orders promptly to increase customer satisfaction.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Provided primary customer support to internal and external customers.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Education
Certificate - Insurance Adjusting
Adjuster Academy of Texas
Online01.2023
Certificate - Phlebotomy
Atlanta Career Institute
Norcross, GA04.2017
High School Diploma -
Rockdale County High School
Conyers, GA05.2015
Skills
- Collection Processes
- Risk Management
- Rules of Evidence
- Advanced Computer Skills
- Customer Experience
- Evidence Review
- Sales
- Healthcare Common Procedure Coding System (HCPCS)
- Estimate Repair Costs
- File Auditing
- Medical Coding
- Claims File Management Processes
Timeline
Insurance Claims Adjuster
Loya Insurance
02.2022 - 03.2023
Call Center Agent
Wipro, Remote
11.2021 - 05.2022
Phlebotomist
Piedmont Hospital
04.2020 - 09.2021
Medical Claims Specialist
LabCorp
05.2018 - 04.2020
Claims Specialist
Automation Staffing
01.2018 - 05.2018
Customer Service Representative
Walmart
09.2016 - 01.2018
Certificate - Insurance Adjusting
Adjuster Academy of Texas
Certificate - Phlebotomy
Atlanta Career Institute
High School Diploma -
Rockdale County High School
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