Sherrica Burton
Jacksonville,FL
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Detail-oriented Examiner with 20 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and Area of expertise. Detail-oriented Examiner with Number years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and Area of expertise. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Claim Examiner
Fortegra
10.2022 - Current
- Adjudicate insurance claims and provide Customer Satisfaction and provide knowledge of claims information and details
- Review insurance claims to verify due process was followed in a investigation and reporting of claims by both claims adjuster and claimants
- Ensure legal compliance
- Assist Customers with police guidelines and disclosures
Customer Care Consultant III
Allstate Insurance
09.2017 - 09.2022
- Provided specific information regarding policy holder services, including products and materials offered by Allstate Insurance Company for Supplemental Benefits Policies
- Address customers concerns about Policy Guidelines and Benefits
- Provided details of Billing and updating ACH information including billing options, advised of current and past due balances to bring account current and explaining billing details
- Provided knowledge of benefits and how to submit claims for consideration of benefits
- Actively listened to customers concerns, show empathy, provide information, answers, and seek resolutions to meet customers satisfaction
- Seek to provide First Call Resolution on each call I encounter with a Customer
- Utilized and follow Quality Assurance guidelines
- Abided and followed HIPAA Rules and Regulations when providing knowledge of services on each call received
Service Lead/Front End Specialist
Southeastern Grocers/Winn Dixie
08.2014 - 09.2017
- Increase customer service by continuously monitoring the needs of the customer
- Educate customers on how to use the self-checkout land when needed
- Boost customer satisfaction by greeting, assisting and thanking customers promptly and courteously
- Resolve customer complaints to obtain full satisfaction immediately while maintaining composure
- Handling Front office monetary transactions for the store
- Opening of front end and closing the day to perform operations and functions of all monetary transactions with customers
- Escalate issues to managers while displaying a positive attitude
- Worked as a TEAM to seek daily goals for company success
- Improve customer service associates by training new associates and providing coaching skills
- Adhere to company policies, guidelines and procedures when coordinating accounting functions
- Preserve and proactively support department service levels and accountability
- Remain abreast of any front-end operations and stay current on changes in policies and procedures
Customer Resolutions Specialists/Collector III
ADT LLC
02.2007 - 06.2014
- Utilized problem-solving skills to cross-train and back-up other customer service managers
- Employed creative ingenuity to solve unresolved and outstanding customer issues
- Exercised exceptional verbal communication skills to clarify delinquency statuses
- Reduced collection accounts by collecting on accounts with a 30-250 day past due status
- Ensured staff members were properly trained on operating procedures and company services
- Boosted customer service by providing timely performance feedback for customer service reps
- Liaised between the internal departments and customers
- Exceeded quality service goals by managing workflow processes effectively
- Ensured accuracy of records in relation to any past due customer account activity
Health Unit Coordinator
Baptist Medical Center
06.2006 - 02.2007
- Ensured accuracy when processing medical orders as requested by the physician for the patient
- Greet Patients, Families, and Friends during visits to see their loved ones
- Used speed and accuracy when putting orders into the system for patients admitted for heart surgery
- Utilized medical terminology and administrative skills for the unit when processing orders
- Interacted with patients/guests to promote a progressive stay so patients rehabilitate themselves
- Provided compassion for ill patients during a pivotal point of time in their lives
- Employed communication skills to ensure the patient had a clear understanding of the necessities of life both before and after surgery
- Reached out to other departments when necessary to seek assistance when needed to address concerns and ensure patient care is address within a timely manner at all times during their stay
Education
Trained Nursing Assistant -
Acumen CNA Training
Jacksonville, FL09.2022
Medical Assistant -
Concorde Career Institute-Jacksonville
Jacksonville, FL10.1996
Fletcher High School -
Fletcher High School
Neptune Beach, FL06.1995
Skills
- Microsoft Office
- Call Center
- Customer Service
- Customer Care
- Medical Terminology
- Phone Etiquette
- HIPAA
- Insurance Verification
- Time Management
- Communication Skills
- Collection Expert
- Multi-Line Phone System
- Microsoft Office Suite
- Telephone Etiquette
- Predictive Dialers
- Customer Retention
- Cost Reduction Strategies
- Microsoft Excel
- Microsoft Word
- Medical office experience
- Avaya
Certification
Trained Nursing Assistant, 09/01/22
Timeline
Claim Examiner
Fortegra
10.2022 - Current
Customer Care Consultant III
Allstate Insurance
09.2017 - 09.2022
Service Lead/Front End Specialist
Southeastern Grocers/Winn Dixie
08.2014 - 09.2017
Customer Resolutions Specialists/Collector III
ADT LLC
02.2007 - 06.2014
Health Unit Coordinator
Baptist Medical Center
06.2006 - 02.2007
Trained Nursing Assistant -
Acumen CNA Training
Medical Assistant -
Concorde Career Institute-Jacksonville
Fletcher High School -
Fletcher High School
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