Ruby Scott
Little Rock,AR
Summary
Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
Ambetter Insurance
06.2016 - 10.2019
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Patient Account Representative
Wellstar Hospital
02.2015 - 06.2016
- Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
- Posted payments and processed refunds.
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Streamlined billing processes for increased efficiency in managing patient accounts.
- Facilitated smooth communications between patients, providers, and insurers, fostering an atmosphere of trust and collaboration.
- Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
- Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
- Ensured compliance with healthcare regulations while processing claims and managing patient accounts.
- Enhanced patient satisfaction by promptly addressing inquiries and resolving account issues.
- Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
- Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
- Responded to patient, family and external payer inquiries.
- Negotiated payment plans with patients experiencing financial difficulties, supporting them in meeting their obligations without undue stress.
- Reduced outstanding balances by implementing effective collection strategies tailored to individual patients'' needs.
Final Quality Inspector
Valpak Temporary Position
03.2014 - 07.2014
- Played a crucial role in maintaining customer satisfaction by ensuring only high-quality products were shipped out for distribution.
- Assisted in developing standardized procedures for consistent product evaluations across all inspectors.
- Promoted a culture of safety within the workplace, adhering strictly to company guidelines while performing tasks.
- Worked closely with the Quality Assurance team to address any discrepancies found during inspections, ensuring swift resolution.
- Contributed to a decrease in product returns by identifying and addressing quality issues before shipment.
- Collaborated with production team members for better understanding of quality requirements and standards.
- Streamlined inspection processes, resulting in increased productivity and reduced turnaround times.
- Improved product quality by consistently inspecting final products and identifying defects.
- Enhanced production efficiency through meticulous attention to detail in the inspection process.
- Communicated with production team members about quality issues.
- Inspected incoming and outgoing materials for accuracy and quality.
Insurance Claims Adjuster
Pilot Catastrophe
06.2012 - 01.2014
- Improved customer satisfaction by providing timely updates and resolutions to their claims inquiries.
- Developed positive relationships with policyholders, fostering trust through transparency during the claim process.
- Identified fraudulent activities through diligent investigation, protecting company assets from potential losses.
- Fostered a supportive work environment by sharing knowledge and expertise with colleagues, promoting collaboration and teamwork.
- Reduced claim processing time by efficiently investigating and evaluating insurance claims.
- Managed catastrophe situations effectively, addressing urgent claims needs quickly and compassionately.
- Assisted policyholders in understanding the complexities of their coverage plans, helping them make informed decisions about their claims.
- Negotiated fair settlements for clients by effectively communicating with all parties involved in the claim process.
- Conducted thorough site inspections to accurately assess property damage for accurate payouts.
- Worked closely with underwriting teams to provide insights into risk assessment based on historical claim data analysis.
Insurance Claims Adjuster
United Automobile Insurance Company
01.2010 - 06.2012
- Developed positive relationships with policyholders, fostering trust through transparency during the claim process.
- Identified fraudulent activities through diligent investigation, protecting company assets from potential losses.
- Fostered a supportive work environment by sharing knowledge and expertise with colleagues, promoting collaboration and teamwork.
- Reduced claim processing time by efficiently investigating and evaluating insurance claims.
- Managed catastrophe situations effectively, addressing urgent claims needs quickly and compassionately.
- Assisted policyholders in understanding the complexities of their coverage plans, helping them make informed decisions about their claims.
- Enhanced team productivity by mentoring new adjusters in best practices and industry standards.
- Negotiated fair settlements for clients by effectively communicating with all parties involved in the claim process.
- Conducted thorough site inspections to accurately assess property damage for accurate payouts.
- Worked closely with underwriting teams to provide insights into risk assessment based on historical claim data analysis.
- Coordinated prompt payments to clients after successful settlement negotiations were reached.
- Attended industry conferences to stay current on trends, legislation, and emerging technologies impacting the insurance field.
- Utilized advanced software tools to manage workload efficiently, prioritizing tasks based on urgency or complexity level.
- Achieved cost savings by negotiating favorable terms with service providers such as contractors, attorneys, and medical experts involved in the claims process.
- Ensured accurate record-keeping within database systems for audit purposes and streamlined retrieval of pertinent information during claim reviews.
- Maintained compliance with state regulations and company policies while handling a high volume of insurance claims.
- Streamlined claim filing processes by implementing an organized system for tracking and managing paperwork.
- Coordinated with repair professionals to ensure quality workmanship and timely completion of repairs on insured properties.
- Verified insurance claims and determined fair amount for settlement.
- Answered customer questions regarding deductibles.
- Examined claims forms and other records to determine insurance coverage.
- Substantiated legitimate claims and denied unjustified claims.
- Prepared summaries of damage, payments, and policy coverage.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Organized, planned and documented materials for Type claims.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Maintained suspicious claims database and prepared reports for supervisors.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Investigated and assessed damage to property and reviewed property damage estimates.
Education
ICD9 And HCPC Coding Class - ICD9 Coding Class. Certificate Received
St Petersburg College
St. Petersburg, FLNo Degree. Business Studies - Business
College of Lake County
Grayslake, ILNo Degree - Business Administration
West Chester University of Pennsylvania
West Chester, PAInsurance Claims Adjusting Course - Insurance And Risk Management
Hillsborough Community College
Tampa, FL12.2000
Skills
- Customer Service
- Problem-solving abilities
- Active Listening
- Critical Thinking
- Data Entry
- Customer Relations
- Problem Resolution
- Call center experience
- Conflict Resolution
- Money handling abilities
- Computer Proficiency
- Complaint Handling
- Complaint resolution
- Payment Processing
- Client Relations
- Customer satisfaction measurement
- Professional telephone demeanor
- Call Center Operations
- Microsoft Outlook
- Follow-up skills
- Call Management
- Paperwork Processing
- Appointment Scheduling
- Order Processing
- Documentation
- Administrative Support
- Microsoft Office Suite
- Data Collection
- Customer Relationship Management (CRM)
- Prioritization
- Building rapport
- Quality Control
- Clerical Support
- Live chat support
- Filing
- Dispute Resolution
- Customer Education
- Product Sales
- Product and service solutions
- Multi-line phone talent
- Coordination
- Sales expertise
- Assertiveness
- Order Fulfillment
- Store maintenance
- Recordkeeping strengths
- Account updating
- Research
- Account Management
- Reading Comprehension
- Spreadsheets
- Service Upselling
- Office equipment proficiency
- Conflict Mediation
- Proofreading
- Retail store support
- Stock management
- Service standard compliance
- Product Promotion
- Document Control
- Brand representation
- Medical terminology knowledge
- Quality Assurance Controls
- Escalation management
- Sales closing
- Project management abilities
- CRM Software
- Information Security
- Product Education
- Key holder experience
- Strategic sales knowledge
- Record preparation
- Consultative Sales
- Credit adjustments
Affiliations
Eastern Star
Timeline
Customer Service Representative
Ambetter Insurance
06.2016 - 10.2019
Patient Account Representative
Wellstar Hospital
02.2015 - 06.2016
Final Quality Inspector
Valpak Temporary Position
03.2014 - 07.2014
Insurance Claims Adjuster
Pilot Catastrophe
06.2012 - 01.2014
Insurance Claims Adjuster
United Automobile Insurance Company
01.2010 - 06.2012
ICD9 And HCPC Coding Class - ICD9 Coding Class. Certificate Received
St Petersburg College
No Degree. Business Studies - Business
College of Lake County
No Degree - Business Administration
West Chester University of Pennsylvania
Insurance Claims Adjusting Course - Insurance And Risk Management
Hillsborough Community College
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