Precious Agoda

Collaborate with other departments to facilitate proper processing of claims.

Analyzed coverage and communicated coverage positions to facilitate claims process.

Adjudicates claims in accordance with company rules and regulations.

Perform accurate claim review.

Analyzed information gathered by investigation and report findings and recommendations.

Conducted research to gather information supporting or refuting claim.

Conducted investigations to determine valid or fraudulent insurance claims.

Shared experience and knowledge of creative resolution techniques to improve claim results.

• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point resolution
• Achieved high satisfaction rating through proactive one-call resolutions of customer
• Developed and maintained strong customer relationships by promptly addressing and resolving customer concerns.
• Researched and resolved account and service problems with friendly, knowledgeable support.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Met customer call guidelines for service levels, handle time and productivity.

• Performed comprehensive audits on submitted claims ensuring accuracy before payment was issued
• Generated reports regarding status updates or changes in the claim's progress for management review
• Developed strong customer service skills to effectively communicate with clients and resolve complex issues