Shannel Kitchens
Scranton,PA
Summary
Highly skilled Insurance Customer Service Representative with broad experience in managing customer inquiries, processing insurance claims and maintaining client records. Strong skills include effective communication, problem-solving and relationship-building abilities. Previous roles have showcased ability to boost customer satisfaction levels and contribute to team success through hard work, attention to detail and excellent organizational capabilities.
Overview
6
6
years of professional experience
Work History
Insurance Service Representative
Nationwide
Columbus, OH
10.2023 - Current
- Provided customer service by answering inquiries and providing accurate information regarding insurance policies.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Assisted in the development and updating of claims policies and procedures to improve efficiency.
- Coordinated with repair facilities and contractors to obtain repair estimates and ensure quality services.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Examined claims, records and procedures to grant approval of coverage.
- Examined automobile policies with third-party liability, accident benefits, and collision benefits.
Claims Representative
AllState
Northbrook, IL
07.2022 - 09.2023
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Resolved complex discrepancies in policyholder files to facilitate accurate claim processing.
- Educated customers on their rights under state and federal regulations governing insurance policies.
- Documented changes in claim statuses using specialized software systems.
Customer Service Agent
Cigna
Scranton, PA
05.2022 - 07.2022
- Perform day-to-day workflow as directed including any special projects and additional tasks as assigned
- Adhere to all company policies and procedures including the company’s attendance and employment policies
- Maintain all company and regulatory compliance guidelines
- Ensure privacy and confidentiality as required by HIPAA and company guidelines
- Promote the company by providing superior customer service
- Actively listens to customers, probes for clarification, and provides guidance based upon each customer’s individual needs
- Communicated with clients regarding account services, statements, and balances
- Entered customer interaction details in sales system to track requests, document problems and record solutions offered
- Provided primary customer support to internal and external customers
- Evaluated customer information to explore issues, develop potential solutions and maintain high-quality service
- Adapted to new applications and maintained knowledge of current technologies
- Demonstrated high attention to detail, organization and management of multiple tasks and projects simultaneously
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction
- Addressed escalated customer service issues sent from sales and service teams to save customer relationships.
Claims Representative
LAZ Parking
New York, NY
08.2018 - 11.2021
- Works with insurance claims to ensure that insurance issues have been settled and claims have been paid out to interested parties
- Built and maintained close relationship with all payer provider representatives to insure proper claims processing
- Documented all customer interactions using appropriate computer systems with strict adherence to confidentiality agreements, policies, and procedures
- Monitored claims with insurance carriers to ensure prompt resolution and provided client feedback
- Maintaining company records and databases, such as filing taxes or updating customer information
- Performing clerical tasks such as typing, filing, and photocopying documents for an organization’s records
- Filing and retrieving information to maintain an orderly system of records for an organization’s operations
- Answering phones, taking messages, and fielding requests from customers or clients via email.
Education
A.A.S. in Healthcare Administration -
Mandl School, the College of Allied Health
New York, NY08.2018
Bachelor of Science - Health Administration
University of Phoenix
Tempe, AZSkills
- Excellent communication and telephone skills
- Proficient skill with Microsoft Office (Word, Excel, PowerPoint) POF software
- Computer skills in most software programs and multitasking
- Billing Resolution
- Conflict Resolution
- Invoicing
- Multitasking
- CMR Software
- Data Entry
- Clerical Support
- Strong interpersonal skills
- Insurance terminology
- Claims Processing
- Effective problem solving
- Policy understanding
- Organization
- Insurance Claim Forms Review
- Claim Amount Calculations
- Eligibility Determination
- Customer Service
- Complaint Handling
- New Policies Processing
- Allocating claims
- Time Management
- Information Verification
- Effective Communication
- Decision-Making
Skillsachievements
- Excellent communication and telephone skills.
- Proficient skill with Microsoft Office (Word, Excel, PowerPoint) POF software.
- Computer skills in most software programs and multitasking.
- Billing Resolution
- Conflict Resolution
- Invoicing
- Multitasking
- CMR Software
- Data Entry
- Clerical Support
Timeline
Insurance Service Representative
Nationwide
10.2023 - Current
Claims Representative
AllState
07.2022 - 09.2023
Customer Service Agent
Cigna
05.2022 - 07.2022
Claims Representative
LAZ Parking
08.2018 - 11.2021
A.A.S. in Healthcare Administration -
Mandl School, the College of Allied Health
Bachelor of Science - Health Administration
University of Phoenix
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