Denise Wright
Columbus
Summary
Results-driven professional with a solid background in claims evaluation and inventory management. Proven ability to collaborate across departments and enhance operational efficiency. Dedicated to delivering fair and timely settlements while adhering to industry regulations.
Overview
21
21
years of professional experience
Work History
Claims Adjuster
Anthem
Midland
02.2022 - Current
- Evaluated claims for accuracy and compliance with company policies.
- Investigated disputed claims by gathering relevant documentation and statements.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
- Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Interpreted insurance policy language to apply appropriate coverage.
Warehouse Worker
Columbus Trophy & Screen Printing
Columbus
09.2017 - 02.2022
- Organized inventory to streamline order fulfillment processes.
- Maintained cleanliness and safety standards in the warehouse environment.
- Assisted in packaging products for timely shipping to customers.
- Collaborated with team members to enhance workflow efficiency.
- Loaded and unloaded shipments while adhering to safety protocols.
- Prepared and completed warehouse orders for delivery or pickup according to schedule.
- Kept shelves, workstations and pallet areas neat and tidy to maintain safe work environment.
- Loaded and unloaded trucks with hand-trucks, pallet jacks, and forklifts.
- Assembled orders according to customer requests.
- Received and tracked incoming inventory shipments.
- Verified accuracy of incoming shipments against purchase orders.
- Packed boxes and stock using organizational guidelines.
Call Center Representative
Blue Cross Blue Shield of GA
Columbus
06.2005 - 04.2017
- Assisted customers with inquiries regarding health insurance plans and services.
- Provided guidance on policy benefits and coverage options to members.
- Resolved customer complaints by identifying issues and offering solutions promptly.
- Maintained up-to-date knowledge of company policies, procedures, and industry regulations.
- Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
- Maintained high levels of professionalism while interacting with customers via phone or email.
- Updated customer accounts, addresses and contact information within call management databases.
- Resolved customer complaints in a timely manner to ensure customer satisfaction.
- Navigated through computer systems to review information and respond appropriately to callers.
Education
High School Diploma -
Jordan Vocational High School
Columbus, GA08-1979
Skills
Claims evaluation
- Policy interpretation
- Fraud investigation
- Documentation review
- Microsoft Office Suite
- Customer relationship management
- Inventory management
- Order fulfillment
- Effective communication
- Attention to detail
- Time management
Timeline
Claims Adjuster
Anthem
02.2022 - Current
Warehouse Worker
Columbus Trophy & Screen Printing
09.2017 - 02.2022
Call Center Representative
Blue Cross Blue Shield of GA
06.2005 - 04.2017
High School Diploma -
Jordan Vocational High School