Claims examiner with extensive knowledge of the medical and property subrogation industries. Energetic, outgoing and driven to reach company goals.
Strong organizational skills
Seasoned in conflict resolution
Adaptive team player
Energetic work attitude
Customer service expert
Promoted from Customer Service, to Claims Processor and Claims Examiner I while at Equian.
Member of the CEO club while at Equian.
Promoted to the email team while at Accent Marketing.
08/2009 to 03/2017
Customer Service/Claims Processor/Examiner IHRI/Trover/Equian － Louisville, KY
Customer service specialist responsibilities included answering incoming calls from members of various health insurances to confirm if treatment was a subrogatable file. Achieved top incoming calls and quality assurance of 100%. Handled member complaints with minimal supervisor intervention.
Promotion to claims processor entailed detailed review of subrogatable files specifically for Kaiser Northern California Health Plan. Built rapport with insurance companies, attorneys and the health plan members to get information required to request for billing. Scheduled work load to handle all file reviews in the form of incoming/outgoing calls, emails, mail and faxes. Extensive knowledge of HIPAA, medical authorizations and subpoenas. Granted remote status and worked from home full time.
Promotion to Claims Examiner I entailed review of billing for accuracy and sending out final liens to requester in order to recover money for the health plan. Actively negotiated with attorneys, insurance providers and members in order to resolve the health care lien. Salaried employee and work from home, so self motivated and set schedule to ensure all tasks were completed in a timely manner. Extensive use of math to determine recovery percentages.
01/2006 to 05/2009
Customer Service RepresentativeAccent Marketing － New Albany, INProvided customer support for members of BJ's Wholesale club. Responsible for answering all incoming calls and emails from members regarding club questions or complaints. Quality assurance and efficiency was exceeding of company goal. Promoted to email team due to my ability to communicate effectively. Organizational skills utilized in order to task myself to follow up with members regarding pending issues.
Bachelor of Arts: Music EducationUniversity Of Louisville － Louisville , KY
PsychologyIndiana University Southeast － New Albany, IN