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Click here or scroll down to respond to this candidateCandidate's Name
CLAIM SPECIALISTPHONE NUMBER AVAILABLE EMAIL AVAILABLE Dallas, TXPROFESSIONAL SUMMARYClaim Specialist with 6+ years of experience processing claims, negotiating settlements, verifying insurance coverage, and reviewing insurance cases. Expert in upholding relationships and communication with insurance departments and clients while organizing and presenting claim review plans. Well-versed in negotiating settlements, resolving claims promptly, and staying up-to-date on local, state, and federal law changes in the insurance field. SKILLS:MS Office Suite - Jira - Workday - HR Information System - CCC - Audatex - Agero - Database - Analysis - Reporting- Effective Communication - Organizational Management - Team Leadership - Customer Relationship Management - Time Management - NegotiationEXPERIENCENigght Audit agentHoliday INN express 2023- PresentARBITRATOR 2022 - Present Allstate, Remote Analyze claims to determine if eligible to arbitration Prepare claims for arbitration submission Intake calls/ make outbound calls while investing claims daily Exceed daily metrics, submitting 10+ claims a day Challenge jurisdictional claims Prioritize emails, voicemails and task daily Thoroughly document claimsCLAIMS ADJUSTER 2018 - 2022 Statefarm, Richardson, TX Deliver lasting solutions while negotiating claim settlements with claimants, closing 8+ claims daily. Impede false/inflated claims streamlining the investigation of each claim to apply for coverage. Abate legal sanctions through applying knowledge of state, federal, and insurance regulations throughout the claim handling process. Exceed weekly metrics by 100% while answering 50+ inbound calls daily and making outbound calls to claimants. Publicize easy accessibility of documentation bycreating a proper filing system. CUSTOMER SERVICE 2018 - 2019 Via Benefits, Dallas, TX Offered exceptional service while handling inbound calls, maximizing customer satisfaction. Accelerated profitability while processing claims and reimbursements of customers, warranting reduced administrative costs. Elevated operational efficiency and minimized clients' complaints regarding databases by reducing redundancy. CLERK III 2016 - 2018 Dallas County, Dallas, TX Promoted cost efficiency while filing court documents for customers, warranting faster resolutions. Improved the attorney's productivity by assisting attorneys with court information, saving cost. Reduced cancellations and no-shows through scheduling appointments with lawyers and clients, improving client engagement. Boosted productivity while assisting with the training of Level I and Level II clerks, ensuring uniformity of work. BOOKKEEPER/ADMINISTRATIVE ASSISTANT 2015 - 2016 The Bridge Breast Reduced risk exposure by maintaining and monitoring financial records to detect suspicious transactions. Maximized data security and confidentiality by entering data into electronic records. Publicized convenience while handling transactions, saving time. PHARMACY TECHNICIAN 2015 - 2016 CVS Health, Richardson, TX Abated prescription errors while receiving/verifying the prescriptions, preventing consequent risks to patients. Enabled effective management of the illness/diseaseby preparing medications for patients. EDUCATION & CERTIFICATIONSNortheast Texas Community College, Northeast, Texas 2017 Eastfield Community College, Mesquite, TX 2012 |
