Tanisha Spencer
Kansas City,MO
Summary
Dynamic claims professional with extensive experience excelling in claims investigation and policy interpretation. Proven track record of reducing resolution times and enhancing training programs. Strong critical thinking and active listening skills drive effective communication and compliance, ensuring high-quality outcomes in fast-paced environments.
Overview
14
14
years of professional experience
Work History
Claimes Adjuster Trainee
Progressive
Lee's Summit, MO
08.2021 - Current
- Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
- Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
Senior Claim Benefit Specialist
CVS Caremark
Kansas City, MO
05.2017 - 06.2021
- Reduced claim resolution time with thorough investigations and efficient communication with policyholders and providers.
- Identified trends in claims data, proposing changes to underwriting guidelines for risk mitigation purposes.
- Participated in industry conferences and workshops to stay informed about emerging trends affecting benefits administration practices.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance throughout the claims process.
- Developed customized training materials to enhance the effectiveness of employee onboarding programs.
Claims Processing Clerk
BroadPath Healthcare
Kansas City, MO
03.2011 - 04.2017
- Adapted quickly to changes in company policy or industry regulations, ensuring continuous high-quality performance as a Claims Processing Clerk.
- Handled high volume of daily claims while consistently meeting deadlines and maintaining attention to detail.
- Achieved high levels of accuracy and consistency in claims processing through diligent attention to detail and a commitment to continuous improvement.
- Demonstrated excellent problem-solving skills by identifying potential issues early on during the claims process and addressing them proactively.
- Actively participated in team meetings and training sessions, contributing valuable insights and staying current on best practices in the industry.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of claims processing.
- Expedited claim resolution times with thorough investigation and timely communication with involved parties.
Education
Adjuster License -
The Adjuster School
Virtual02.2020
Pharmacy Technician License -
Metropolitan Community College
Kansas City, MO05.2012
High School Diploma -
Hickman Mills High School
Kansas City, MO05.2009
Skills
- Claims investigation
- Damage assessment
- Property valuation
- Policy interpretation
- Critical thinking
- Active listening
- Decision-making
- Claims processing
- Advanced computer skills
Timeline
Claimes Adjuster Trainee
Progressive
08.2021 - Current
Senior Claim Benefit Specialist
CVS Caremark
05.2017 - 06.2021
Claims Processing Clerk
BroadPath Healthcare
03.2011 - 04.2017
Adjuster License -
The Adjuster School
Pharmacy Technician License -
Metropolitan Community College
High School Diploma -
Hickman Mills High School