Kayla McGhee
@kaylamcghee
Experienced licensed claims representative with a focus on customer service.
United StatesWhat I'm looking for
With over five years of experience in the auto insurance industry, I have developed a strong expertise as a Licensed Claims Representative and Customer Service professional. My detail-oriented approach and critical thinking skills have enabled me to assess and manage claims effectively, ensuring timely and accurate resolutions for my clients. I pride myself on delivering superior customer service experiences, which has contributed to my previous employers achieving the highest customer service ratings.
Currently, I work as a Medical Claims Resolution Specialist at WIPRO, where I analyze claim submissions for accuracy and verify coverage based on policy terms. My role involves customer interaction, fraud detection, and compliance management, ensuring that all claims adhere to state and federal regulations. Previously, I served as an Auto Claims Specialist at State Farm, where I investigated and settled claims while maintaining effective communication with customers in a fast-paced environment.
Experience
Work history, roles, and key accomplishments
Medical Claims Resolution Specialist
WIPRO
Jun 2024 - Present (11 months)
Analyzed claim submissions for accuracy, verifying coverage based on policy terms, and determining appropriate payment amounts. Examined medical records, billing codes, and other supporting documentation to assess claim validity. Responded to inquiries from policyholders, providers, and brokers regarding claim status and processing, identified potential fraudulent claims, and ensured adherence to
Auto Claims Specialist
State Farm
Dec 2021 - Mar 2024 (2 years 3 months)
Investigated, evaluated, negotiated, and settled auto claims, applying knowledge of policies and insurance regulations when determining coverage, liability, and damages. Contacted customers by telephone, written correspondence, and various electronic media. Effectively managed work through task driven queues while multi-tasking in a fast-paced call center environment.
Customer Success Representative
Urgently
Jul 2020 - Dec 2021 (1 year 5 months)
Performed an elite level of customer service while coordinating service technicians in the field, drivers on the road, and company dispatchers/owners. Developed and delivered weekly high-value report dashboard to company management measuring all aspects of support activity. Assisted new and established agents with resolving particularly challenging calls as a member of the support team and acted a
Education
Degrees, certifications, and relevant coursework
Langston Hughes High School
High School Diploma, High School
2009 - 2014
Grade: 3.5 GPA
Activities and societies: Member of the Community and Debate Clubs High School
Pursued a High School Diploma. Graduated in May 2014.
The Art Institute of Atlanta
Bachelor of Arts, Culinary Arts
Studied for a Bachelor of Arts degree. Focused on the Culinary Arts major.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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