Tonya Williams
Forkland,AL
Summary
Accomplished Claims Processor at Allstate Corp, adept in accuracy and precision, and renowned for elevating customer service standards. Leveraged critical evaluation and policy interpretation skills to streamline claims processing, significantly enhancing operational efficiency. Mentored new hires, embodying professionalism and fostering a culture of continuous improvement. Achieved a notable increase in claims processing accuracy, directly contributing to the company's financial and customer satisfaction metrics.
Overview
22
22
years of professional experience
Work History
Claims Processor
Allstate Corp
10.2020 - Current
- Evaluated accuracy and quality of data entered into agency management system.
- Provided support during internal and external audits, ensuring accurate representation of the company''s claim history.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Monitored changes in legislation that could potentially impact the way claims are processed or paid out by insurance companies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Negotiated settlements with policyholders, balancing their needs with the financial interests of the company.
- Identified and reported potential fraud or abuse related to claims to protect system's integrity.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Verified client information by analyzing existing evidence on file.
- Followed up with customers on unresolved issues.
Floor Supervisor
Rivers Edge Bingo
02.2015 - 09.2020
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Oversaw employee performance, corrected problems, and increased efficiency to maintain productivity targets.
- Served as a positive role model for staff, exemplifying strong leadership qualities and a commitment to company values.
- Upheld proper visual merchandising standards on retail floor and windows.
- Determined staffing needs, developing schedules to staff all shifts.
- Supervised team of helpers, laborers and material movers to efficiently complete tasks.
Customer Service Lead
SYKES
05.2013 - 01.2015
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Trained, oversaw, and mentored new team members to strengthen performance and job expertise.
- Managed high call volumes while maintaining a professional demeanor, resulting in increased customer loyalty.
- Reduced average call handling time through efficient problem diagnosis and resolution techniques.
- Established strong relationships with clients, leading to repeat business and positive feedback.
- Exceeded performance goals consistently through effective communication and problem-solving skills.
- Assisted with onboarding new hires by sharing expertise in company policies, procedures, systems usage.
- Handled escalated customer complaints professionally, ensuring prompt resolution and follow-up actions were taken as necessary.
Clinical Coordinator
DCH Regional Medical Center
09.2009 - 05.2013
- Coordinated, monitored, assigned, and documented patient and clinical care activities.
- Conducted regular performance assessments and provided constructive feedback to staff members, promoting high-quality service delivery.
- Devised and implemented clinical protocols to ensure high-quality patient care.
- Coordinated continuing education opportunities for staff members to stay current on industry advancements and best practices.
- Created weekly schedules for nurses, taking into account sick days and vacation time.
- Worked closely with clinic administrators to maintain a safe, clean and well-organized environment in which patients could receive care.
- Upheld quality assurance procedures to maintain patient safety and satisfaction.
- Identified areas of opportunity for process improvements, leading efforts to implement changes that resulted in enhanced operational efficiency across all aspects of the clinic''s function.
- Optimized resource allocation by regularly monitoring clinic operations and adjusting staffing levels as needed.
- Mentored junior staff members, fostering a culture of professional growth and continuous improvement within the clinical team.
Technical Lead
Greenetrack Bingo
12.2002 - 10.2009
- Designed and developed forward-thinking systems that meet user needs and improve productivity.
- Increased application stability by regularly monitoring performance metrics, addressing bottlenecks proactively to minimize downtime occurrences.
- Optimized resource allocation across multiple concurrent projects by closely tracking team capacity levels against project deadlines and milestones.
- Mentored junior developers through regular 1-on-1 meetings, providing guidance on best practices, coding standards, and career growth opportunities.
- Coordinated with cross-department teams like QA, DevOps, and Support to ensure seamless end-to-end software delivery process.
- Provided educational expertise and mentoring to junior team members.
- Implemented continuous integration and deployment strategies for faster release cycles and improved application reliability.
- Evaluated and recommended new tools and technologies that resulted in increased development efficiency and up-to-date technical skillsets within the team.
- Maintained close communication with clients throughout project life cycles for accurate progress reporting and prompt issue resolution.
- Improved systems with addition of new features and infrastructure.
- Led a team of developers to successfully deliver high-quality software projects on time and within budget constraints.
Education
Cosmetology - Cosmetology
Shelton State Community College
Tuscaloosa, AL05.2008
High School Diploma -
Greene County High School
Eutaw, AL 05.2002
Skills
- Claims review
- Accuracy and Precision
- Transactions reconciliation
- Claims
- Claims Processing Software
- Policy Interpretation
- Data entry proficiency
- Medical terminology knowledge
- Critical Evaluation
- Allocating claims
- Claims Processing
- Customer Service
Timeline
Claims Processor
Allstate Corp
10.2020 - Current
Floor Supervisor
Rivers Edge Bingo
02.2015 - 09.2020
Customer Service Lead
SYKES
05.2013 - 01.2015
Clinical Coordinator
DCH Regional Medical Center
09.2009 - 05.2013
Technical Lead
Greenetrack Bingo
12.2002 - 10.2009
Cosmetology - Cosmetology
Shelton State Community College
High School Diploma -
Greene County High School
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