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Skills

  • Claims Documentation Review
  • Documentation abilities
  • High-level accuracy in data entry
  • Operational improvement
  • Reporting skills
  • Business operations
  • Metric equipment
  • Customer service excellence
  • File Management and Organization
  • Data accuracy and cross-referencing

Work Experiences

  • Achieved a 27% reduction in filing errors.
  • Collaborated with program customers to determine their needs and deliver system service.
  • Had an excellent attendance record and was always on time for work.
  • Averaged less than 81% errors annually.
  • Assisted in creating a customer feedback system.
  • Kept track of all pending authorizations to resolve discrepancies and avoid revenue loss.
  • Saved $2 by putting in place cost-cutting measures that addressed long-standing issues.
  • Acted as a liaison between adjusters and claimants.
  • Assisted in fraud detection efforts.
  • Accurately entered data on claims initiation.

Summaries

  • Achieved results during three years.
  • Adept at cross-referencing claims data.
  • Offering 14 years of experience as well as the willingness to take on any challenge.
  • Ambitious Claims Intake Representative focused on continual improvement and achieving career goals that align with enhancing claims operations and customer satisfaction.
  • Aimed to achieve career goals.
  • Achieved error-free claims documentation.
  • Hardworking Claims Intake Representative with 2 years of telecommuting experience meeting customer needs.
  • Adept at collaborating with underwriting teams.
  • Within Miscellaneous, senior Claims Intake Representative and outstanding performer in risk assessment and client relations.
  • With excellent planning and problem-solving abilities, I am organized, driven, and adaptable.

Accomplishments

  • Collaborated on the successful rollout of new claims tracking software, reducing update times by 79% within the first one year.
  • Detailed and documented high-volume claims intake for Meridian, supporting streamlined processing for 4 claims per month.
  • Aided clients in finalizing their submissions quickly by guiding them through complex documentation, reducing return times by 7 days.
  • Contributed to achieving a team success rate of 23% on-time claims submissions by creating clear tracking and documentation procedures.
  • Worked closely with the underwriting team to resolve coverage disputes, decreasing resolution times by 6 hours on average.
  • Supported a team of 2 entry-level representatives by providing training on system processes, reducing intake submission errors by 47%.
  • Became subject matter expert on Salesforce, assisting team members with troubleshooting and optimizing claim submission workflows.
  • Improved claimant onboarding and intake accuracy by creating user guides and FAQs with metric for streamlined interactions.
  • Revised and updated intake protocols in cooperation with marketing leadership, enhancing workflow and cutting processing time by 12 minutes per claim.
  • Implemented quality checks for claims documentation, which decreased the time spent correcting errors by 26%.

Affiliations

  • Project Management Institute
  • Society of Insurance Research (SIR)
  • International Claim Association (ICA)
  • Jaycees
  • Insurance Data Management Association (IDMA)
  • Society of Human Resource Management
  • Certified Claims Professional Accreditation Council (CCPAC)
  • American Society for Quality (ASQ), Insurance Special Interest Group
  • Rotary International
  • International Council of Nurses

Certifications

  • First Aid/CPR Certified
  • Fundamentals of Claims Compliance Certification
  • Certified Customer Service Representative (CCSR)
  • Google Certified Professional Cloud Architect
  • CompTIA A+ Technician
  • Customer Relationship Management (CRM) Software Certification - QuickBooks
  • Licensed Claims Adjuster Texas
  • Associate in Claims (AIC) Designation
  • CompTIA Network+
  • Apple Certified Associate (ACA)

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