Demetria Clay
@demetriaclay
Licensed property & casualty insurance producer focused on accurate, compliant claims documentation and resolution.
United StatesWhat I'm looking for
I’m a Licensed Property & Casualty Insurance Producer with over 10 years of experience supporting insurance and claims-related processes, including documentation review, claims investigation support, and account investigation. I bring a highly detail-oriented approach to analyzing records, verifying policyholder information, and resolving coverage inquiries.
I’m skilled in policy coverage interpretation, loss documentation & record review, and data analysis & verification across multiple systems. I consistently maintain regulatory compliance, document thoroughly, and escalate complex issues to ensure timely resolution.
Most recently, I’ve worked in remote patient and insurance claims environments reviewing and verifying patient and insurance information, investigating discrepancies, and upholding strict privacy and documentation standards. I’m seeking an Entry-Level Claims Adjuster role where my investigative, documentation, and customer resolution skills can contribute to accurate and efficient claim handling.
Experience
Work history, roles, and key accomplishments
Reviewed and verified patient and insurance information to support accurate claims processing and billing documentation. Investigated account data discrepancies, maintained federal privacy compliance, and escalated complex issues for timely resolution.
Helped policyholders select appropriate property and casualty coverage and explained policy limits, deductibles, and claims procedures. Documented endorsements and policy changes in internal systems while maintaining compliance with insurance regulations and underwriting guidelines.
Customer Service Representative
Bluecross Blueshield of Tennessee
Jul 2022 - Jan 2024 (1 year 6 months)
Resolved high-volume insurance inquiries related to claims, billing, and benefits by investigating account issues and coordinating cross-functional resolutions. Reviewed customer and policy records to ensure claims accuracy and maintained detailed case notes for issue tracking.
Pharmacy Services Representative
CVS Health
Oct 2019 - Jun 2022 (2 years 8 months)
Processed prescription claims by verifying insurance coverage information and reviewing customer records for accurate billing and claims submissions. Updated policyholder account and payment documentation to support correct claim handling.
Handled insurance-related inquiries through digital communication channels, resolving benefits and claims questions for policyholders. Maintained detailed documentation of customer interactions and case updates for accurate issue tracking.
Education
Degrees, certifications, and relevant coursework
Chattanooga State Community College
Associate of Applied Science, Clinical Dental Assisting
Grade: GPA: 3.6; Cum Laude
Activities and societies: Phi Theta Kappa honor society
Earned an Associate of Applied Science in Clinical Dental Assisting from Chattanooga State Community College. Graduated cum laude and was a member of Phi Theta Kappa honor society.
Availability
Location
United StatesAuthorized to work in
Job categories
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