Reshonda Hamilton
2860 Marti Ln, Montgomery
Summary
Full-time position sought that leverages strong interpersonal skills, time management, and problem-solving abilities. Proficient in insurance verification processes, ensuring accurate and timely patient information handling. Strong analytical skills utilized to identify and resolve discrepancies, enhancing operational efficiency. Knowledgeable in industry regulations and best practices, contributing to reduced claim rejections.
Overview
21
21
years of professional experience
Work History
Insurance Verification Specialist
Progressive Auto Insurance
11.2024 - Current
- Maintained high accuracy in data entry, significantly reducing errors and enhancing efficiency.
- Increased customer satisfaction through expert guidance on DMV rules and state procedures.
- Facilitated improved customer experience by assisting individuals with complex forms and processes.
- Reviewed databases and tools to update state reporting and verify insurance information.
- Collaborated with process consultants and claims adjusters to refine insurance verification guidelines.
- Managed high-stress interactions effectively, ensuring calm support for frustrated clients.
- Monitored procedure changes to maintain up-to-date knowledge of DMV processes.
Consultant Services
Progressive Insurance
11.2023 - Current
- Processed policy updates and changes accurately, ensuring client needs were met in a timely manner.
- Utilized company software to track, gather information and answer inquiries.
- Handle inquiries and transactions for single or multiple lines of business and states.
- Modified, updated and processed existing policies. Add and delete vehicles, drivers, and coverage from existing policies.
- Calculated adjustments, premiums and refunds. Process cancellations, renewals, reinstatements, endorsements, payments, and state/federal filings on Progressive systems.
- Stayed current on products, services and procedures.
Manager/Customer Service
N & R TRUCKING LLC
02.2017 - 04.2023
- Followed through with client requests to resolve problems.
- Created and reviewed invoices to maintain accuracy while working with customers to answer questions and address payment issues.
- Assessed call center trends to identify improvement opportunities and devise forward-thinking approaches to better align processes with intended results.
- Supervised employees and assessed performances to determine training needs and define accurate plans for decreasing process lags.
- Introduced higher standards for customer service and increased efficiency by streamlining operations.
Medical Claims Representative
Inventurus Knowledge Solutions
02.2009 - 04.2014
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Processed and recorded new policies and claims.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Medical Operations Manager
Lincare
01.2004 - 02.2009
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Communicated with patients, ensuring that medical information was kept private.
- Implemented best practice standards for billing resulting in substantial reduction of accounts receivable delays.
Education
Associate Of Business Administration - Business Administration And Management
Walden University
02.2014
Skills
- Customer satisfaction and sustainability
- Performance adaptability
- Multi-system navigation
- Problem-solving and multitasking
- Verbal and written communication
- Stress tolerance
- Claims investigation and processing
- Coverage determination and policy knowledge
- Medical claims submission
- Decision-making
- Negotiation skills
- Quality orientation
Accomplishments
Multiple customer compliments awards
Multiple Customer Compliments Award Certificates
Multiple Customers that have left excellent customer service compliments with supervisors.
Timeline
Insurance Verification Specialist
Progressive Auto Insurance
11.2024 - Current
Consultant Services
Progressive Insurance
11.2023 - Current
Manager/Customer Service
N & R TRUCKING LLC
02.2017 - 04.2023
Medical Claims Representative
Inventurus Knowledge Solutions
02.2009 - 04.2014
Medical Operations Manager
Lincare
01.2004 - 02.2009
Associate Of Business Administration - Business Administration And Management
Walden University
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