NA'JAH RUSHING
GRANDVIEW
Summary
Customer service professional with over 6 years of experience in billing, policy/claims management, sales, and insurance. Skilled in managing CRM systems, problem-solving, and multitasking to enhance customer experiences. Proven ability to resolve conflicts and build strong client relationships. Proficient in digital literacy (Microsoft Office/Google) and committed to performance-driven results, consistently contributing to organizational success and high customer satisfaction.
Overview
9
9
years of professional experience
Work History
Customer Service Associate/Claims Specialist
Liberty Mutual
2022.01 - Current
- Supports customer needs by efficiently handling inbound calls, addressing inquiries about renewals, coverage, billing, and policy adjustments.
- Provides recommendations for protecting assets while educating on insurance product options through upselling and cross-selling techniques.
- Meets quality standards by achieving targets for call quality, handling time, and first-call resolutions.
- Maintains accurate data records within various computer systems.
- Conducts thorough investigations of insurance claims, gathering evidence and interviewing witnesses and claimants.
- Approves or denies claims in compliance with insurance policy provisions, internal procedures, and state and federal regulations.
Short Term Disability/Absence Claims
Guardian Life
2019.07 - 2022.01
- Analyzed Short-Term Disability (STD) and leave claims (FMLA, State Paid Leave, State Disability) to determine eligibility in accordance with plan provisions and federal/state regulations.
- Reviewed medical documentation and claim details to render accurate, timely benefit determinations and payment decisions.
- Interpreted policy language and contract provisions to ensure compliant claim adjudication.
- Processed claim payments and maintained detailed documentation to support audit and quality assurance standards.
- Managed assigned claim inventory within established Service Level Agreements (SLAs), consistently meeting turnaround and accuracy metrics.
- Communicated claim decisions clearly and professionally with claimants, employers, and healthcare providers to ensure understanding and resolution.
Inside Sales/Customer Service
Spring Venture Group
2017.04 - 2019.07
- Consulted with Medicare eligible members to identify their healthcare needs and recommend appropriate Medicare plans.
- Assessed member needs using active listening and targeted questioning to provide personalized coverage solutions.
- Supported current members with inquiries regarding benefits, coverage, and plan usage while maintaining detailed records of interactions with customers.
- Managed multiple CRMs and research tools simultaneously, maintaining organization and efficiency in a high-volume environment.
- Demonstrated proficiency at explaining all products and services.
- Promoted supplemental Medicare products including dental, vision, hearing, Part D, and Medigap plans.
- Ensured compliance with company policies and state/federal regulations.
Education
HIGH SCHOOL DIPLOMA -
Center High School
Skills
- Customer Service
- Problem Solving
- Multitasking
- Communication
- Decision-making
- Adaptability
- Digital Literacy
- Effective Listening
- Claims Processing
- Benefits Eligibility Review
- Organization
- Time Management
Timeline
Customer Service Associate/Claims Specialist
Liberty Mutual
2022.01 - Current
Short Term Disability/Absence Claims
Guardian Life
2019.07 - 2022.01
Inside Sales/Customer Service
Spring Venture Group
2017.04 - 2019.07
HIGH SCHOOL DIPLOMA -
Center High School