Theodora Thomas
Murfreesboro,TN
Summary
Professional with significant expertise in customer service within insurance industry. Proven ability to handle complex inquiries, resolve issues efficiently, and provide clear, accurate information. Strong focus on collaboration and achieving results, adapting seamlessly to changing demands. Skilled in policy management, claims processing, and maintaining high levels of customer satisfaction. Reliable team player with excellent communication and problem-solving abilities.
Overview
24
24
years of professional experience
Work History
Insurance Customer Service Representative
TTEC
05.2024 - 08.2024
- Managed high call volume while maintaining professionalism, empathy, and attention to detail in each interaction.
- Processed policy updates and changes accurately, ensuring client needs were met in a timely manner.
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
- Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Assisted clients in filing claims, coordinating with adjusters to expedite the process and secure fair settlements.
Customer Service Representative
TurboTax
01.2024 - 04.2024
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests regarding all Tax products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Assisted customers with preparing tax forms for current years taxes.
Claims Representative
Kaiser Permanente
03.2023 - 10.2023
- Reviewed claim files to determine eligibility and adherence to policy guidelines.
- Investigated claims by obtaining statements from involved parties and assessing damages.
- Processed claims for various types of insurance policies, collecting all necessary documentation.
- Communicated with clients to gather information and clarify details regarding claims.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
Customer Service Advocate
Small Business Administration
09.2020 - 10.2022
- Provided clear information about company policies and procedures.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Supported call center associates by taking on escalated calls, handling complex concerns and achieving customer satisfaction targets.
- Utilized CRM software to track customer interactions, ensuring seamless handoff between support agents when needed.
Housing Specialist
TNHAF
03.2022 - 08.2022
- Assisted clients in understanding their rights and responsibilities as tenants, promoting healthy landlord-tenant relationships.
- Maintained accurate records of client interactions, ensuring confidentiality and efficient case management.
- Explained rental and housing regulations to clients and helped each discover best options for housing.
- Reviewed documentation and input data into computer system to complete eligibility process, re-certifications and tenant move-outs.
- Assisted applicants in filling out housing applications and verifying assets.
- Established positive rapport with clients by providing exceptional customer service and addressing their unique needs.
- Evaluated rental applications thoroughly, verifying income eligibility and background checks for potential tenants.
Quality Assurance Analyst
BroadPath Healthcare
10.2017 - 03.2018
- Provided expert guidance on document formatting, content requirements, and approval processes, enhancing team knowledge and skill sets.
- Mentored specialists, fostering a culture of continuous learning and professional growth within the team.
- Evaluated third-party tools streamlining the QA process through strategic selection implementation.
- Improved customer satisfaction by promptly addressing concerns and providing effective solutions to reported issues.
- Monitored product quality at all stages of production process.
- Facilitated training sessions empowering team members to adopt new tools and methodologies effectively.
Team Leader
Arise (Rogers Tele Communications)
02.2005 - 05.2006
- Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
- Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
- Managed conflict resolution among team members, fostering a positive and collaborative work environment.
- Maintained an inclusive and diverse team culture, promoting respect and understanding among all members.
- Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
- Mentored junior staff members, helping them develop their leadership potential and advance in their careers.
- Increased customer satisfaction ratings by closely monitoring service quality standards and addressing any issues promptly.
- Educated staff on organizational mission and goals to help employees achieve success.
Claims Representative
Alpine Access (Cigna)
04.2003 - 11.2004
- Reviewed claim files to determine eligibility and adherence to policy guidelines.
- Investigated claims by obtaining statements from involved parties and assessing damages.
- Processed claims for health of insurance policies, collecting all necessary documentation.
- Communicated with clients to gather information and clarify details regarding claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
Insurance Claims Specialist
Dr. P Vijay Reddy
04.2000 - 03.2003
- Coordinated with medical professionals to gather necessary information.
- Maintained organized records of all claims and communications.
- Assisted clients in understanding coverage and claim procedures.
- Communicated with clients to provide updates on claim status.
- Reviewed insurance claims for accuracy and completeness.
- Investigated claims by gathering relevant evidence and statements.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
- Evaluated and settled complex insurance claims in strict timeframes.
- Maximized client retention by addressing concerns promptly and professionally, consistently demonstrating empathy and understanding during difficult situations.
- Followed up with customers on unresolved issues.
Education
GED -
Brunswick High School
Lawrenceville, VA06-1981
Skills
- Complaint handling
- Customer service
- Insurance coverage verification
- Medical terminology
- Insurance claim forms review
- Teamwork and collaboration
- Critical thinking
- Claims processing
- Denied claims identification
- Attention to detail
- Decision-making
- Active listening
Timeline
Insurance Customer Service Representative
TTEC
05.2024 - 08.2024
Customer Service Representative
TurboTax
01.2024 - 04.2024
Claims Representative
Kaiser Permanente
03.2023 - 10.2023
Housing Specialist
TNHAF
03.2022 - 08.2022
Customer Service Advocate
Small Business Administration
09.2020 - 10.2022
Quality Assurance Analyst
BroadPath Healthcare
10.2017 - 03.2018
Team Leader
Arise (Rogers Tele Communications)
02.2005 - 05.2006
Claims Representative
Alpine Access (Cigna)
04.2003 - 11.2004
Insurance Claims Specialist
Dr. P Vijay Reddy
04.2000 - 03.2003
GED -
Brunswick High School
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