Experience

Club Car

• Motor Vehicle Manufacturing
• 700 & Above Employee

• Warranty Claims Specialist

  • Sep 2020 - Present

  Provide warranty support to dealer services and sales departments. Prepare record, reconciles warranty claims, and submits claims for payment Code warranty claims using labor operations codes, review and dispute rejected claims. Analyze mechanical evidence to ensure recommended repairs are justified Handle dealer, and field staff inquiries regarding protection product coverage Worked directly in conjunction with sales department and Service Manager/Writer to ensure that warranty work is correctly identified, communicated, and reconciled in a reasonable timeframe that advocates for the dealer. Maintained warranty payments and scheduled and submitted them to accounting for review. Show less



Argos Health

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Third Party Liabiity Claims Specialist

  • Sep 2017 - Oct 2020

  • Reviewed and researched accident claims to investigate possible leads • Bill no-fault and third-party liability carriers when appropriate • Request documentation from insurance representatives when no no-fault insurance is available. Review and research insurance claims to determine possible payment sources. • Contact various sources including insurance professionals, patients, and other parties to verify relevant data • Coordinate with payors to ensure appropriate filing guidelines are met for reimbursement • Request appropriate information, both verbally and written, from appropriate parties to ensure proper claim disposition • Ensure that appropriate billing guidelines and standards are met based on payer and/or state. • Make written or verbal appeals to payers on denied claims • Evaluate liability cases according to a multitude of factors, including accident type, patient involvement, patient degree of fault, and available insurance coverage. • Assess state No-Fault laws to determine the availability and extent of first party coverage, and inform uncooperative patients about the proper coordination of available insurance benefits • Appeal underpayments made for any reason other than exhaustion of benefits. • Resolve bodily injury liability claims by asserting and enforcing liens against the liable insurance company Show less



TRUTHERAPY LPC

• United States
• Medical Practices
• 1 - 100 Employee

• Claims Specialist

  • Sep 2014 - Nov 2017

  • Monitor accounts receivable by ensuring payment before claims reach the timely filing limit. • Identify reason for rejections and know the proper action for correction. Supported monthly, quarterly, and yearly cleanups. • Ensured all pre-authorization issues are communicated in a timely manner. • Perform outpatient billing processes in a timely and accurate manner. • Monitor accounts receivable by ensuring payment before claims reach the timely filing limit. • Identify reason for rejections and know the proper action for correction. Supported monthly, quarterly, and yearly cleanups. • Ensured all pre-authorization issues are communicated in a timely manner. • Perform outpatient billing processes in a timely and accurate manner.