Tosha Gibson
McKinney
Summary
Experienced Claims Representative with background in insurance, healthcare, and customer service. Strengths include strong analytical skills, ability to handle multiple tasks efficiently, and exceptional communication abilities. Previous work has involved investigating insurance claims, negotiating settlements, and providing superior service to policyholders. Have consistently improved efficiency and reduced claim processing timeframes in past roles.
Overview
12
12
years of professional experience
Work History
Claims Representative
United Healthcare
Richardson
08.2023 - Current
- Processed insurance claims using internal systems and software tools.
- Reviewed claim documentation for accuracy and completeness.
- Communicated with clients to gather necessary information for claims.
- Collaborated with healthcare providers to resolve claim disputes.
- Educated clients about policy details and claim procedures.
- Maintained detailed records of claims and communications in databases.
- Assisted team members in navigating complex claims issues and solutions.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
Lending Specialist
Goldman Sachs
Richards
10.2020 - 08.2023
- Investigated and resolved accounting and servicing concerns
- Maintained up-to-date knowledge of product and service changes
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Assisted customers with completing loan applications and other paperwork
- Analyzed loan applications to assess creditworthiness and financial stability.
- Collaborated with clients to gather necessary documentation for loan processing.
Collections Agent
Capital One
Richardson
02.2014 - 10.2020
- Maintained high volume of calls and met demands of busy and productive group.
- Monitored customer accounts for payment delinquency and initiated collection efforts.
- Worked in call center environment handling manual and automatically dialed outbound calls
Education
Bachelor Of Business Administration - Business Management
Texas Woman's University
Denton, TXSkills
- Strong written & verbal communication
- Consumer Lending Processes
- Lending Software Systems
- Customer Needs Assessments
- Collections Proficiency
- Conflict Resolution Technique
- Google Docs
- Strong critical thinking and decision making
- Claims processing
- Claim documentation review
- Customer communication
- Dispute resolution
- Policy education
- Insurance regulations
- Customer relationship management
- Data entry accuracy
- Problem solving
Timeline
Claims Representative
United Healthcare
08.2023 - Current
Lending Specialist
Goldman Sachs
10.2020 - 08.2023
Collections Agent
Capital One
02.2014 - 10.2020
Bachelor Of Business Administration - Business Management
Texas Woman's University