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@cnajeecharlton
Detail-oriented resolution specialist with expertise in claims processing.
I am a dedicated Resolution Specialist with over five years of experience in the healthcare and insurance sectors. My expertise lies in reviewing, researching, and processing claims, ensuring accuracy and compliance with established standards. At Honor HealthCare, I have consistently met productivity goals while analyzing trends and providing insightful reports to improve operational efficiency.
Previously, I worked as a Claims Specialist at Progressive Ins, where I honed my customer service skills and managed complex inquiries from both internal and external stakeholders. My ability to prioritize tasks and communicate effectively has been instrumental in resolving claims efficiently and maintaining high customer satisfaction levels.
Throughout my career, I have demonstrated a commitment to continuous improvement, engaging in internal audits and coaching to enhance team performance. I am passionate about leveraging my skills to contribute to a dynamic team focused on delivering exceptional service and achieving organizational goals.
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Work history, roles, and key accomplishments
Honor HealthCare
Oct 2022 - Mar 2025 (2 years 5 months)
Provided expertise by reviewing, researching, investigating, negotiating, processing, and adjusting claims. Analyzed and identified trends, providing reports as necessary, while consistently meeting established productivity, schedule adherence, and quality standards.
Progressive Ins
Dec 2019 - Sep 2022 (2 years 9 months)
Utilized customer service skills to interact by phone, email, and mail with multiple internal and external contacts, offering general assistance and maintaining availability. Executed paperwork exchange, including salvage handling and mailing of total loss paperwork, and initiated calls to external customers, medical providers, and local authorities to request and expedite paperwork.
All American Healthcare Agency
May 2015 - Dec 2019 (4 years 7 months)
Processed Medical, Dental, and Pharmacy claims and personal requests according to specified procedures and standards in a timely manner. Responded to complex customer calls, resolving inquiries via live chats, email, or phone regarding products, benefits packages, and care plans.
Degrees, certifications, and relevant coursework
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