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Caylai Turner

@caylaiturner

Medical claims specialist at State Farm Insurance who reviewed claims, determined coverage, and explained decisions to policyholders and providers.

United States

Message

What I'm looking for

I'm seeking a long-term remote role in claims or insurance operations where accuracy and clear communication matter.

At State Farm Insurance, I managed medical claims from first report through resolution, documenting interactions and claim actions for policyholders, attorneys, medical providers, and internal partners.

I reviewed claim information, insurance documents, and policy details to determine coverage and eligibility. I also explained benefits, procedures, and decisions so customers and their representatives understood the next steps.

At Rockwall CAD, I analyzed business assets and records to support property valuations, then presented findings to review boards. Earlier, I coordinated audit documentation at Omnisys and handled customer-facing administrative work at Fenton Nissan.

Experience

Work history, roles, and key accomplishments

Medical Claims Specialist

State Farm Insurance

Jan 2024 - Jun 2026 (2 years 5 months)

Managed a high-volume medical claims caseload, documenting interactions and claim actions from first report through resolution. Reviewed documentation and policy details to determine coverage and eligibility, and explained benefits and decisions to customers and representatives.

Medical Claims Processing Coverage Determination Eligibility Verification Policy Interpretation Benefits explanation Insurance Documentation Claim Resolution Caseload Management Correspondence Microsoft Word Excel Outlook Claims Management Systems Electronic Records

Business Personal Property Appraiser

Rockwall CAD

Jan 2019 - Dec 2023 (4 years 11 months)

Managed relationships with local business owners through appraisal cycles, answering questions about valuations and resolving property tax disputes. Conducted financial and operational analyses to determine accurate property values and presented findings to review boards.

Business Personal Property Financial Analysis Operational Analysis Audit Coordination Compliance Tracking Evidence Preparation Review Board Customer Education Dispute Resolution

Receptionist

Fenton Nissan

Jan 2017 - Dec 2019 (2 years 11 months)

Answered incoming calls, responded to customer questions, and directed callers and visitors to appropriate departments. Scheduled appointments and handled administrative tasks, keeping front-office operations organized.

Inbound Call Handling Customer Education Appointment Scheduling Records Management Front Desk Operations Multitasking Outlook

Audit Specialist

Omnisys

Jan 2015 - Dec 2017 (2 years 11 months)

Coordinated audit documentation for multiple providers, tracking requests to ensure timely submission and compliance. Communicated with staff and stakeholders to resolve documentation issues and maintained accurate audit records.

Audit Coordination Compliance Tracking Regulatory Deadline Coordination Records Management Documentation Review Communication Skills Excel