CLARISSA SPRIGGS
Joplin,MT
Summary
Professional with over 10 years of experience in customer service solutions and data entry. Skilled in CRM systems, Epic, claims processing, and prior authorizations. Committed to delivering exceptional customer service by utilizing customer service best practices and capturing accurate information to input into company systems.
Overview
10
10
years of professional experience
Work History
Prior Authorization Representative
TTEC/Cigna
06.2023 - Current
- Handle high volume of incoming calls from members, providers and health care professionals
- Processed prior authorization requests efficiently, ensuring compliance with insurance guidelines as well as accurately documenting all approvals and denials.
- Coordinated communication between healthcare providers and insurers to resolve authorization issues.
- Provided a high level of professional customer service while assisting callers with the prior authorization process
Claims Processing Specialist
VXI/Kaiser Permanente
09.2022 - Current
- Process claims efficiently, ensuring compliance with company policies and regulatory requirements.
- Train new team members on claims procedures and software systems
- Reach out to Providers and members to gather data for claims,
- Use epic to research patient accounts.
AUTO CLAIMS FNOL INSURANCE AGENT
TTEC/USAA
07.2022 - 06.2023
- Provided exceptional customer service while answering a high call volume of inbound calls to assist USAA members with filing auto loss claims.
- Showcased expert data entry skills by capturing and inputting precise statements into the system.
- Built rapport and trust with USAA members through the auto claims process by actively listening and understanding the members wants and needs.
- Coordinated members tows, repairs, inspection services, and adjuster assignment.
- Cross-sold insurance products to existing clients to reach sales targets.
CXC SALES CONSULTANT
CarMax
11.2020 - 07.2022
- Handled inbound calls and web leads to assist with guiding customers through the car buying process.
- Assisted with selecting vehicles, securing vehicle holds, placing transfers, and processing payments.
- Processed credit applications and reviewed offers, ensuring smooth transactions.
- Met sales goals by actively promoting Express Pickups, Home deliveries, and MaxCare, boosting service adoption.
DUAL CSR AND MEDICARE CLAIMS A/B1 REP
Maximus Federal
10.2017 - 11.2020
- Answered a high call volume assisting Medicare beneficiaries with claims, doctor selection, drug plan enrollment, and general questions.
- Demonstrated excellent customer service skills by actively listening and showing empathy and understanding to beneficiaries in difficult health situations.
- Within 3 months was promoted to being dual trained to also receive calls from Marketplace consumers assisting them with enrolling into Marketplace insurance plans and assisting with general technical account issues and questions.
- Promoted again at 6 months to handle Medicare Part A and B claims calls. Was responsible for accurately researching processed Medicare claims that were either approved or denied.
- Received outstanding CSAT scores, reflecting customer satisfaction and service quality.
OFFICE ASSISTANT/LEASING AGENT
Express Employment Professionals (temp. job)
08.2016 - 10.2017
- Handled general office duties, coordinated office meetings and was responsible for efficient office operations.
- Scheduled and conducted apartment showings and move-outs, documenting unit damages with detailed reports.
- Conducted thorough background, credit, and rental history checks, ensuring reliable tenant selection.
- Demonstrated proficient data entry skills by inputting and managing rent payments and deposits to maintain accurate financial records.
Education
No Degree - Pharmacy Tech
Penn Foster
Chandler, AZ08-2026
High School Diploma - undefined
McLouth High School
McLouth, KS05.2003
Skills
- Insurance verification
- Detail-oriented
- Medical terminology
- Pharmacology
- Prescription coordination
- Co-payment collection
- Insurance authorization
- Creative problem solving
- Data analysis
- Customer relationship management (CRM)
- Technical SEO
- Customer service
- Active listening
- Critical thinking
- Data entry
- Call center experience
- Computer proficiency
- Basic medical terminology
- Benefit coverage
- Authorizations
- Patient referrals
- Medical billing procedures
Accomplishments
A member of the National Society of Leadership and Success. You must have a 3.0 GPA or higher, be nominated by a faculty member, and show leadership qualities. Less than 20% of students achieve this award/nomination. At request a personalized letter of recommendation can be provided!
Timeline
Prior Authorization Representative
TTEC/Cigna
06.2023 - Current
Claims Processing Specialist
VXI/Kaiser Permanente
09.2022 - Current
AUTO CLAIMS FNOL INSURANCE AGENT
TTEC/USAA
07.2022 - 06.2023
CXC SALES CONSULTANT
CarMax
11.2020 - 07.2022
DUAL CSR AND MEDICARE CLAIMS A/B1 REP
Maximus Federal
10.2017 - 11.2020
OFFICE ASSISTANT/LEASING AGENT
Express Employment Professionals (temp. job)
08.2016 - 10.2017
High School Diploma - undefined
McLouth High School
No Degree - Pharmacy Tech
Penn Foster