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Claims Representative Litigation Examiner Resume Example

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Jessica Claire
, , 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Summary

Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Personable and dedicated Customer Service Representative with extensive experience. Solid team player with upbeat, positive attitude and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses. Capable Claims . Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements.

Skills
  • Office equipment proficiency
  • Call Center Operations
  • Adaptive team player
  • Arbitrating disputes
  • Litigation management
  • Emergent animal care
  • Safety precautions and measures
  • Coverage determination
  • Policy knowledge
  • Documentation research
  • Settlement agreements
  • Patient rapport
  • Reliable and trustworthy
  • Working collaboratively
  • Decision-making
Experience
04/2017 to Current
Claims Representative /Litigation Examiner Desert Choice Schools San Tan Valley/ Queen Creek, AZ,
  • Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote effective service times for all parties.
  • Reviewed documentation and accounts to gain full picture.
  • Provided quality customer service to all assigned, insured and claimants throughout claims process to deliver timely service to customers.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Examined claims, records and procedures to grant approval of coverage.
  • Verified that patients had proper insurance coverage prior to any procedures or appointment scheduling.
  • Coordinated implementation of document databases for legal team document review and production.
  • Assisted legal staff with collation and organization of case documentation and administrative tasks.
  • Aided senior leadership during executive decision-making process, meeting with clients to research cases, collect data, prepare settlement packages and interpret information for daily report generation.
  • Performed variety of automated support tasks necessary to prepare, organize, index, develop and manage exhibits, evidence and data relevant to cases.
  • Obtained, reviewed and summarized medical records at direction of trial attorneys, consulting outside experts and arranging for medical examinations when relevant to cases.
03/2012 to 04/2017
Cashier Team Lead /Western Union Agent Cashier Modern Animal Studio City, CA,
  • Assisted with training new cashiers and customer service team members to increase speed of onboarding.
  • Applied proper tare procedures when ringing up scalable items to maintain accurate pricing.
  • Oversaw work of 25 cashiers to identify strengths and weaknesses in customer service, payment processing or merchandising plans and maximize performance.
  • Maintained high productivity by efficiently processing cash, credit, debit and voucher program payments for customers.
  • Collaborated with senior management to optimize teams with department transfers and promotions for skilled workers.
  • Trained and mentored new cashiers to maximize performance with skilled, efficient and knowledgeable team members.
06/2011 to 09/2012
Teacher's Assistant Little Hearts Daycare City, STATE,
  • Promoted student learning by providing individualized and small group support to reinforce classroom topics.
  • Prepared lesson materials and visual aids to reinforce lesson concepts.
  • Prepared bulletin boards, classroom materials and individual student portfolios to support teacher plans.
  • Monitored students in class, hallways and cafeteria to supervise, enforce rules and support lead teacher.
  • Conducted special assessments and tutoring sessions to support individual student needs.
  • Cleaned and organized classrooms, materials and supplies to support maximum efficiency.
  • Helped students master learning concepts through one-on-one and small group tutoring.
06/2009 to 06/2011
Veterinary Assistant Abraham Lincoln High School Veterinary Lab City, STATE,
  • Provided direct care for animal patients in post-operative recovery, closely monitoring vital signs and progress.
  • Assessed health conditions, symptoms and history of animals and delivered treatment.
  • Restrained and stabilized animals during examination and treatment to safeguard against accidental injuries.
Education and Training
Expected in 06/2011
High School Diploma:
Abraham Lincoln High School - Brooklyn, NY
GPA:
Expected in 05/2016
Bachelor of Arts: Psychology
Long Island University - Brooklyn, NY
GPA:
  • Minor in Art and Sociology
  • 3.5 GPA

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Resume Overview

School Attended
  • Abraham Lincoln High School
  • Long Island University
Job Titles Held:
  • Claims Representative /Litigation Examiner
  • Cashier Team Lead /Western Union Agent Cashier
  • Teacher's Assistant
  • Veterinary Assistant
Degrees
  • High School Diploma
  • Bachelor of Arts