Dynamic Specialty Claims Analyst with Edfinancial Services, able to manage high-volume caseloads while ensuring accuracy and confidentiality. Proven problem-solver with strong attention to detail and exceptional interpersonal skills, consistently enhancing customer satisfaction and achieving performance metrics. Committed to ongoing professional development and effective teamwork in fast-paced environments.
Overview
12
12
years of professional experience
Work History
Specialty Claims Analyst
Edfinancial Services
06.2023 - Current
Maintained strict confidentiality with all personal data as per company guidelines.
Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
Participated in ongoing training programs to stay current on industry developments and maintain a strong understanding of relevant laws and regulations affecting the claims process.
Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
Maintained claims for Bankruptcy, School Closure, and Borrower Defense to Repayment.
Customer Service Representative II
Edfinancial Services
10.2022 - Current
Handled inbound and outbound calls, as well at chat services.
Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Resolved customer complaints with empathy.
Handled escalated calls efficiently, finding satisfactory resolutions for customers.
Responded to customer requests for products, services, and company information.
Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
Exceeded performance metrics consistently.
Maintained detailed records of customer interactions and transactions, ensuring accurate documentation.
Customer Service Representative
PHEAA
12.2021 - 09.2022
Specialized in PSLF calls and application review.
Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Resolved customer complaints with empathy.
Maintained detailed records of customer interactions.
Improved resolution time with effective problem-solving for customer complaints.
Addressed customer inquiries to ensure satisfaction.
Met customer call guidelines for service levels, handle time and productivity.
Certified Nursing Assistant
Charles Morris Nursing and Rehabilitation Center
10.2013 - 01.2022
Provided high-quality personal care services such as bathing, grooming, dressing, and feeding to ensure patient dignity.
Assisted patients with daily living activities for enhanced comfort and wellbeing.
Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
Maintained a clean, safe environment by sanitizing surfaces, changing linens, and disposing of waste properly.
Improved patient care quality by monitoring and recording vital signs, fluid intake, and output.
Reduced fall incidents by implementing safety measures like bed alarms and proper positioning techniques.
Enhanced team efficiency by promptly responding to call lights and reporting changes in patient condition to nurses.
Utilized therapeutic communication, empathy and active listening skills to encourage and develop positive relationships with patients.
Built rapport with patients and families, providing emotional support during difficult times.
Served as an advocate for each patient's needs during shift handoffs or interdisciplinary conferences with other healthcare professionals.
Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
Improved patient satisfaction with empathetic listening and addressing concerns promptly.
Education
Associate of General Studies - Liberal Arts And Sciences
Community College of Allegheny County
Pittsburgh, PA
05-2021
Skills
Interpersonal and written communication
MS office
Computer skills
Active listening
Relationship building
Teamwork
Time management
Attention to detail
Problem-solving abilities
Multitasking Abilities
Accomplishments
Currently in the Leadership Development Program with the completion of Blaze Program. Expected to graduate September, 2025.
Timeline
Specialty Claims Analyst
Edfinancial Services
06.2023 - Current
Customer Service Representative II
Edfinancial Services
10.2022 - Current
Customer Service Representative
PHEAA
12.2021 - 09.2022
Certified Nursing Assistant
Charles Morris Nursing and Rehabilitation Center
10.2013 - 01.2022
Associate of General Studies - Liberal Arts And Sciences