Tiffany Nesmith
Jacksonville
Summary
Detail-oriented Claims Representative with a proven track record in processing and analyzing customer claims, leveraging strong problem-solving skills to resolve complex issues efficiently. Adept at maintaining accurate records and providing exceptional customer service, I excel in high-pressure environments while ensuring compliance with insurance regulations. Recognized for my ability to collaborate effectively across departments, I bring a commitment to excellence and a deep understanding of policy knowledge.
Overview
18
18
years of professional experience
1
1
Certification
Work History
CLAIMS REPRESENTATIVE
Statefarm
Jacksonville
03.2023 - 04.2025
- Processed and analyzed customer claims with accuracy and attention to detail
- Maintained accurate records of all communications with customers
- Utilized effective problem solving techniques to resolve complex customer issues
- Managed a high volume of incoming calls from customers, providing excellent customer service
- Collaborated with internal departments on escalated claims disputes
- Documented detailed notes about each interaction with the customer
- Stayed up-to-date on local, state and federal law changes in insurance field to maintain knowledge
FRONT DESK RECEPTIONIST
Digestive Disease Consultants
Jacksonville
05.2019 - 03.2023
- Greeted and welcomed visitors in a professional manner while managing multiple tasks simultaneously
- Provided a high level of customer service to all clients
- Managed incoming calls, directing them to appropriate staff members or taking detailed messages as necessary
- Performed data entry and administrative duties such as filing, scanning documents, updating databases
- Scheduled appointments for clients using office calendar system and provided updates on changes or cancellations when needed
- Assisted with completion of forms or sign-in procedures
- Received payments and recorded receipts for services
- Monitored front desk traffic to support customer satisfaction
CNA
Lanier Manor
Jacksonville
02.2012 - 05.2019
- Administered medications to patients based upon physician or nurse guidelines
- Supervised and assisted patients during showers and baths
- Provided transportation to medical and recreational appointments
- Provided compassionate and patient care to individuals with disabilities in a residential setting
- Provided guidance to clients in order to help them achieve their goals and objectives related to independent living skills
- Maintained accurate records of client data including incident reports, progress notes, treatment plans
- Assisted clients with daily living tasks such as hygiene, meal preparation, dressing, grooming, housekeeping duties
DSP
Florida Mentor
Jacksonville
05.2007 - 02.2012
- Cleaned and organized client's living quarters to make living conditions more hospitable.
- Established personal relationships with clients to maintain patient comfort and care.
- Administered bedside and personal care, such as ambulation, and personal hygiene assistance.
- Responded appropriately to physical, emotional and developmental needs of residents.
- Prepared and maintained records of client progress and services performed, reporting changes in client condition to manager and supervisor.
- Observed physical and mental condition, intake and output and exercise to monitor client condition.
- Prepared and maintained records of client progress and performed services.
- Completed and submitted clinical documentation in accordance with agency guidelines.
Education
CNA -
Jacksonville, FL05.2019
Skills
- Policy Knowledge
- Decision-Making
- Telephone Etiquette
- Customer Service
- Insurance Claim Forms Review
- Appointment Scheduling
- Claims processing
- Call handling
- Problem solving
- Attention to detail
Certification
CNA
Timeline
CLAIMS REPRESENTATIVE
Statefarm
03.2023 - 04.2025
FRONT DESK RECEPTIONIST
Digestive Disease Consultants
05.2019 - 03.2023
CNA
Lanier Manor
02.2012 - 05.2019
DSP
Florida Mentor
05.2007 - 02.2012