Tiffany Murray
Douglasville,USA
Summary
Claims and accounts resolution professional with 7+ years of experience in claims investigation, documentation review, billing support, and dispute resolution. Proven ability to analyze claim data, research policy coverage, identify trends, and resolve escalated issues in compliance-driven environments. Strong background in claims processing, customer relations, and documentation accuracy with transferable experience aligned to healthcare insurance follow-up, denials resolution, and accounts receivable functions.
Overview
11
11
years of professional experience
Work History
Claims Resolution Specialist
Bank of America
01.2020 - Current
- Reviewed and processed high-volume claims to ensure compliance with company policies and regulatory standards.
- Investigated complex and escalated claims by analyzing account activity, supporting documentation, and claim history.
- Analyzed claims data to identify trends and discrepancies, contributing to process improvement.
- Negotiated claim outcomes within established guidelines and maintained detailed documentation for audits and reviews.
Claims Administrator
CarMax
02.2018 - 01.2020
- Managed claims processing for insurance-related products while ensuring regulatory compliance.
- Reviewed documentation to determine eligibility, coverage accuracy, and risk factors.
- Researched account histories to resolve discrepancies and collaborated cross-functionally to improve workflows.
Claims Representative
Comcast
02.2015 - 01.2018
- Evaluated claims and billing disputes for policy compliance and validity.
- Worked with customers to gather documentation and clarify claim details.
- Analyzed data for accuracy and developed reports outlining claim trends for leadership review.
Education
Associate Degree -
Community College of Denver
Denver, COSkills
- Claims Investigation & Resolution
- Insurance Follow-Up & Research
- Denials & Coverage Determination
- Accounts Review & Billing Support
- Documentation Review & Analysis
- Policy Interpretation & Compliance
- Claims Trend Analysis & Reporting
- Escalated Case Management
- Customer & Payer Communication
- Data Analysis & Quality Assurance
- Conflict Resolution & Negotiation
- HIPAA-Aligned Documentation Handling
Timeline
Claims Resolution Specialist
Bank of America
01.2020 - Current
Claims Administrator
CarMax
02.2018 - 01.2020
Claims Representative
Comcast
02.2015 - 01.2018
Associate Degree -
Community College of Denver