Tara Wright
Summary
Customer service expert specializing in medical charts and dental insurance with proven experience in processing claims. Demonstrates exceptional customer service skills while ensuring efficient claims processing. Committed to delivering high-quality support and resolving issues promptly. Recognized for enhancing customer satisfaction and streamlining operations.
Overview
15
15
years of professional experience
Work History
COMMERCIAL CLAIMS SPECIALIST
KEMPER
05.2025 - 09.2025
- Managed a diverse caseload of complex commercial claims, resulting in timely settlements and satisfied clients.
- Conducted interviews with all involved parties, reviewed police reports, and compiled additional investigative information to establish liability and evaluate damages.
- Frequently communicated with policyholders, brokers, attorneys, and claimants throughout the claims process.
- Drafted ROR letters addressing coverage concerns and issued denial letters to clarify claim status.
- Detected potential fraud indicators and escalated questionable claims for in-depth investigation.
- Developed strong professional relationships with external partners such as service providers and vendors to foster a collaborative approach to claims resolution.
- Consistently met or exceeded performance metrics related to productivity, quality assurance scores, file completion timelines, among other benchmarks established by management teams.
CLAIMS ANALYST II
NATIONAL GENERAL
09.2021 - 02.2025
- Managed a caseload of standard and non-standard auto claims, resulting in timely settlements and satisfied clients.
- Conducted coverage investigations and recorded statements from all parties to ensure thorough claim assessments.
- Reviewed police reports, witness statements and accident evidence to ascertain fault.
- Negotiated fair and reasonable settlements with claimants.
- Drafted ROR letters for potential coverage issues and communicated policy language to insured for clarity.
- Facilitated subrogation by identifying responsible third parties and collaborating with collection teams to recover funds for the insurer.
- Served as a mentor for junior adjusters by providing guidance on claim handling techniques, company procedures, and industry best practices.
SUPPORT SPECIALIST
DELTA DENTAL
06.2014 - 07.2019
- Addressed customer issues and complaints promptly and efficiently aiming for 1 call resolution.
- Assisted customers with inquiries, providing accurate information and resolving issues efficiently.
- Assisted customers in navigating company website and viewing benefits, improving overall user experience.
- Cultivated strong customer relationships through exceptional service, fostering loyalty and retention.
- Documented customer interactions in CRM systems to ensure accurate follow-up and enhance service continuity.
- Collaborated with team members to establish best practices, ensuring consistent delivery of high-quality customer service.
- Actively attended educational seminars to boost knowledge and performance levels.
HEDIS Medical Chart Reviewer
Outcomes Health Information Solutions LLC
Alpharetta , GA
09.2010 - 04.2012
- Reviewed medical charts to ensure compliance with health information standards, enhancing data integrity.
- Adhered strictly to confidentiality rules when handling sensitive material from patient files.
- Entered and verified patient insurance, demographic, and health information into software, maintaining accurate records.
- Collaborated with other departments within a health system such as Quality Assurance and Improvement teams on initiatives relating to accurate record keeping practices.
- Provided friendly and knowledgeable service by answering questions and fulfilling requests, improving patient satisfaction.
Education
Georgia Perimeter College -
GEORGIA PERIMETER COLLEGE - GEORGIA STATE UNIVERSITY
GEORGIA01-2014
High School -
NORCROSS HIGH SCHOOL
NORCROSS, GEORGIA01-2003
Skills
- Claims processing
- Critical Thinking
- Problem Solving
- Ability to Thrive in High Pressure Environments
- Customer Service
- Communication Skills
- Teamwork
- Independent Work
Timeline
COMMERCIAL CLAIMS SPECIALIST
KEMPER
05.2025 - 09.2025
CLAIMS ANALYST II
NATIONAL GENERAL
09.2021 - 02.2025
SUPPORT SPECIALIST
DELTA DENTAL
06.2014 - 07.2019
HEDIS Medical Chart Reviewer
Outcomes Health Information Solutions LLC
09.2010 - 04.2012
Georgia Perimeter College -
GEORGIA PERIMETER COLLEGE - GEORGIA STATE UNIVERSITY
High School -
NORCROSS HIGH SCHOOL