Diamond Brown
Wilson
Summary
Skilled in handling complex insurance claims and policy processing with experience in navigating through various insurance software systems. Demonstrates strong analytical skills, adept at interpreting policies and efficiently resolving claims to the satisfaction of all parties involved. Known for maintaining high accuracy levels in document processing and data entry, contributing to streamlined operations and improved customer service outcomes. Continuously seeks ways to optimize workflows and enhance team productivity, leading to more efficient claim resolution processes.
Overview
14
14
years of professional experience
Work History
Claims Processor
Conduent
03.2022 - Current
- Processed insurance claims efficiently using proprietary software systems.
- Reviewed claim submissions for accuracy and completeness.
- Communicated with clients to gather necessary documentation and information.
- Ensured compliance with regulatory requirements in all claims processed.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
Senior Benefit Consultant
GoHealth
Wilson
02.2020 - 03.2023
- Prepared documents such as applications, contracts, endorsements, and riders related to health insurance policies.
- Ensured compliance with state laws governing health insurance coverage.
- Developed and implemented health insurance plans for clients in accordance with their needs.
- Fielded inbound calls from customers inquiring about alternative insurance options to generate sales opportunities.
Inbound Sales Representative
Charter Communications
11.2016 - 03.2020
- Engaged customers to identify needs and recommend suitable services.
- Educated potential clients about Charter Communications' products and promotions.
- Processed customer orders accurately using internal software systems.
- Provided exceptional customer service to ensure satisfaction and retention.
Retention Supervisor
Centurylink
08.2012 - 11.2016
- Oversaw call center operations, driving retention, sales, and quality objectives.
- Coached 15+ team members to enhance retention rates and service quality.
- Reviewed call interactions, providing actionable feedback to improve service delivery.
- Championed policy compliance and training, aiding hiring, retention, and discipline initiatives.
- Developed and executed training programs on compliance and customer interaction strategies.
- Evaluated skill gaps, implemented tailored coaching, achieving consistent team metrics and boosting employee engagement.
Education
Dental Assistant -
Some College (No Degree) -
Rocky Mount High School
Skills
- Claims processing
- Insurance documentation
- Customer relationship management
- Quality assurance
- Effective communication
- Medical terminology
- Allocating claims
- Accuracy and precision
- Technical aptitude
- Claims review
- Critical evaluation
- Insurance regulations
- Application review
- Documentation processing
- Background in insurance
- Insurance coverage verification
- Insurance sales
- Client retention
- Private insurance
- Licensed insurance agent
- CRM tracking
Timeline
Claims Processor
Conduent
03.2022 - Current
Senior Benefit Consultant
GoHealth
02.2020 - 03.2023
Inbound Sales Representative
Charter Communications
11.2016 - 03.2020
Retention Supervisor
Centurylink
08.2012 - 11.2016
Dental Assistant -
Some College (No Degree) -
Rocky Mount High School