Shakayla Rogers
Mobile
Summary
Personable and dedicated customer service representative with extensive experience in industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
10
10
years of professional experience
2015
2015
years of post-secondary education
Work History
Technical Support Representative
Alorica
11.2023 - Current
- Handled customer service issues by providing guidance or escalating for advanced support.
- Assisted customers with various types of technical issues via email, live chat, and telephone.
- Served as the first point of contact for incoming technical service calls and emails.
- Walked customers through common phone hardware and software configurations to maximize service functionality.
- Demonstrated advanced product knowledge to solve customer issues.
- Supported customers with online billing, access, and account issues.
- Delivered remote assistance for technical issues using screen sharing, mouse and keyboard control, and other tools.
Claims Adjuster
Pilot Catastrophe
Mobile
09.2019 - 02.2023
- Evaluated insurance claims to determine validity and coverage.
- Investigated claims by interviewing involved parties and reviewing documentation.
- Collaborated with policyholders to gather necessary information for claims processing.
- Utilized claims management software to track progress and document findings.
- Communicated claim decisions clearly to clients and stakeholders, ensuring understanding.
- Assisted in training new adjusters on company procedures and best practices.
- Maintained accurate records of all claims interactions and outcomes for reporting purposes.
- Resolved disputes by mediating between clients and insurance providers effectively.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.
- Maintained accurate documentation of all claim activity within designated system.
- Reviewed medical records, police reports and other documents related to claim investigations.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
- Performed special projects upon request from management; completed tasks efficiently while meeting deadlines.
- Gathered information from various third parties to determine claim acceptability.
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Analyzed facts of loss including photographs, diagrams and other evidence to identify potential sources of recovery.
- Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
- Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
- Negotiated and settled claims according to information presented through reports, research, and data verification.
- Conducted witness interviews to assist claim information gathering process.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Organized files into logical categories; maintained complete records according to established procedures.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
Claims Processor
Blue Cross and Blue Shield
Mobile
01.2016 - 02.2017
- Processed claims for medical services and treatments efficiently.
- Reviewed documentation for accuracy and compliance with policy guidelines.
- Communicated with healthcare providers to gather necessary information.
- Utilized claims processing software to manage and track claim status.
- Resolved discrepancies in claims through thorough investigation and analysis.
- Collaborated with team members to streamline claims processing procedures.
- Assisted customers by answering inquiries regarding claim status and benefits.
- Maintained detailed records of processed claims for future reference.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Verified claim data correctness in preparation for processing.
- Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Assisted customers via telephone inquiries related to their specific claim status or general questions about the company's services.
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Analyzed contracts and claim systems to apply appropriate benefit amounts.
- Conducted and documented comprehensive investigations to negotiate settlements or deny claims.
- Provided technical guidance and training to new staff members regarding claim processing procedures.
- Maintained accurate records of all processed claims in accordance with departmental requirements.
- Coordinated benefits with medical insurance plans and Medicare providers.
- Evaluated the validity of assigned claims by verifying that services are medically necessary according to established guidelines.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Resolved complex issues associated with denied or underpaid claims through negotiation with payers.
- Identified trends in denials or rejections due to incorrect coding or billing practices by providers.
- Managed escalated customer complaints pertaining to denied or delayed payments in a timely manner.
- Documented decisions on each claim based on research findings and applicable benefit plans.
Accounts Receivable Specialist
Clarity Clinic
01.2016 - 02.2017
- Generating timely and accurate customer invoices on a monthly basis.
- Maintaining accounts receivable records to ensure aging is up to date.
- Verifying invoices for appropriate documentation prior to payment.
- Monitoring incoming payments and ensuring they are applied correctly.
- Reconciling accounts receivable ledger with the general ledger.
- Resolving discrepancies between customer payments and invoices.
- Handling customer inquiries regarding bills or payments.
- Assisting with month-end closing activities such as preparing journal entries.
- Developing reports related to accounts receivable activity.
- Working with other departments to resolve billing issues or disputes.
- Ensuring compliance with all applicable laws and regulations related to accounts receivable activities.
Education
Ben C Rain High School
Mobile, USASkills
- Technical troubleshooting
- Customer support
- Claims processing
- Remote assistance
- Software navigation
- Client relations
- Documentation management
- Data analysis
- Workflow optimization
- Communication skills
- Conflict resolution
- Team collaboration
- Attention to detail
- Problem solving
- Time management
- Script adherence
- Analytical thinking
- User guidance
- Java full stack
- Customer service expert
- Ticket support system management
- Hardware upgrades
- Remote support
- Network configuration
- Software diagnosis
- Ticket management
- Microsoft certified solutions associate (MCSA) certificate
- Needs assessment
- Systems analysis
- Windows 10
References
References
Education
High School Diploma
Ben C Rain High School
May 2014
Other Activities
Timeline
Technical Support Representative
Alorica
11.2023 - Current
Claims Adjuster
Pilot Catastrophe
09.2019 - 02.2023
Claims Processor
Blue Cross and Blue Shield
01.2016 - 02.2017
Accounts Receivable Specialist
Clarity Clinic
01.2016 - 02.2017
Ben C Rain High School