An ambitious, performance-driven, administrative professional looking to transition into the Human Resources field. Passionate about helping others and able to communicate well in the most sensitive situations. Ability to work well independently as well as on a team in a high-pressure environment. Detail oriented, eager to learn, and constantly focusing on productive client relationships.
Attention to Detail
As an Economic Self-Sufficiency Specialist, I was recognized for handling the most calls in the entire call center, and several times for exceeding daily call goals of 55.
As a Triage Team Lead/Intake Specialist I was recognized for having Perfect attendance and several times for entering the most referrals.
As a Medical Claims Adjuster I have been recognized twice for outstanding customer service.
Medical Claims AdjusterApr 2016 to Current Progressive Insurance － Maitland, FL
Identify wage loss expenses and wage exposures on medical claims.
Interact daily with customers taking statements and research medical records to understand nature and extent of injury and medical conditions.
Plan and conduct coverage investigations.
Evaluate medical claims for potential fraud issues, loss control, and recovery in accordance with insurance policy contracts, medical bill coding rules, and state regulations.
Review a variety of claims related mail each day, including claim forms, medical bills, medical records, and attorney correspondence.
Process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
Makes claim determinations to approve noncomplex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system.Refers cases as appropriate to team lead; maintains professional client relationships.
Triage Team Lead/Intake SpecialistSep 2013 to Dec 2015 One Call Care Dental and Doctor － Tampa, FL
Promptly answer, screen and process medical service requests and telephone inquiries for dental and doctor appointments with.
strict adherence to confidentiality agreements and policies and procedures.
Collect and enter patient intake information into the.
appropriate medical service software system to initiate the transaction.
Check daily reports and acquire authorizations for.
treatment from WC adjusters.
Economic Self Sufficiency Specialist ISep 2012 to Sep 2013 Department of Children and Families － Tampa, FL
Worked in a call center setting making phone interviews to determine eligibility for receiving public assistance benefits to.
include Supplemental Nutrition Assistance Program (food stamps), Medicaid and or temporary cash assistance.
with additional resources for housing, food, utility assistance, and where to report abuse, neglect, and benefit fraud.
consultation and expert advice to management or other groups on technical, systemsrelated, or process related topics.
Clerical AssistantAug 2007 to Jul 2012 Florida State University Office of Financial Aid － Tallahassee, FL
answering and directing phone calls
receiving, sorting and distributing incoming mail
maintaining filing systems
photocopying, scanning and faxing
preparing and sending outgoing mailings and packages
monitoring and ordering inventory of office supplies
Bachelor of Science, Family & Child Sciences2012Florida State University － Tallahassee, FL
Served as a Mentor/Life Coach for internship with SoUnique