Experience

Medical Solutions, Inc

• United States
• Medical Equipment Manufacturing
• 1 - 100 Employee

• Medical Claims Processor

  • Mar 2011 - Present

  Analyzed claims to determine extent the extent of my company’s liability, making approval and denial decisions and negotiate settlements with claimants in accordance with policy provisions. I collaborated with insurance agents and interviewed claimants to correct errors, rectify omissions and investigate questionable fraud. Key Results: Completed more than 50 claims daily on a daily basis. Provided optimum service to policyholders, negotiated fair settlements and identified fraudulent claims. Maintained a superior quality rating of 97% in file handling and claims resolution since March of 2011 still exceeding the 85% departmental goal. Developed a strong understanding of insurance policies and legal issues through completion of a series of classes’ coupled with in-depth, multi-week claims training. Show less



Sitel Group

• Outsourcing and Offshoring Consulting
• 700 & Above Employee

• USAA/Claims Processing Representative

  • Feb 2008 - Sep 2010

  Handled in-coming telephone calls from policy and calls from policy holders and claimants reporting accidents, and completed initial reports. Reviewed and settled undisputed non-injury claims and assessed claims for possible subrogation. Processed subrogation with third party to recover money paid out by USAA where appropriate. Handled in-coming telephone calls from policy and calls from policy holders and claimants reporting accidents, and completed initial reports. Reviewed and settled undisputed non-injury claims and assessed claims for possible subrogation. Processed subrogation with third party to recover money paid out by USAA where appropriate.



sitel, INC

• USAA/Claims Processing Representative

  • Feb 2008 - Sep 2010

  Handled in-coming telephone calls from policy and calls from policy holders and claimants reporting accidents, and completed initial reports. Reviewed and settled undisputed non-injury claims and assessed claims for possible subrogation. Processed subrogation with third party to recover money paid out by USAA where appropriate. Key Results: My monitored calls were used as training throughout the center to show quality and handling procedures of a live call. Demonstrated the ability to fill in at a moment’s notice, quickly mastering new systems, processes and workflows. Resolved months of backlogged work, restored order and organization to processes/records in disarray, researched and solved billing problems and corrected invoicing and journal entry errors that had previously been missed. Received “ Exceptional Service “ scores on performance appraisals consistently Maintained a service quality level at 99% per call rate consistently Show less



Amarillo College

• United States
• Higher Education
• 500 - 600 Employee

• Financial Aid

  • Jan 2006 - Dec 2008

  Handled multifaceted clerical tasks (e.g., data entry, filing, records management and billing) as the assistant to the registrar and admissions offices. Coordinated travel arrangements, maintained database and ensured the delivery of premium service to students. Quickly became a trusted assistant known for “can-do” attitude, flexibility and high-quality work. Key Results: Communicated effectively with multiple departments to plan meetings and prepare welcome packages for new students. Established strong relationships to gain support and effectively achieve results. Helped coordinate dozens of recruitment events (average of 12 large gatherings per year) that contributed to consistently high enrollment levels. Developed innovative PowerPoint presentation used by the Office of Admissions to market executive support programs to potential students. Earned excellent marks on performance reviews, with citations for excellence in areas including work volume, accuracy and quality; ability to learn and master new concepts; positive work ethic; and commitment to providing unsurpassed service. Show less



BAPTIST ST ANTHONY’S HOSPITAL

• Certified Nurse Assistant

  • Sep 1997 - Sep 2000

  Handled multiple departments by Resource Pool. Assisted RN by providing patient care. Checked on patients on a regular basis. Assisted doctors and nurses with patient charts to ensure patient received the highest quality medical care. Key Results: Responsible for checking vital signs and monitoring the patient's general condition, reporting vital information to RNs as needed. Responsible for properly charting patients nutritional intake, vital signs, glucose level, temperature. Responsible for correctly enter patients information into the system and doctors orders. Communicated effectively with doctors, nurses, laboratory, and pharmacy to make sure patient received the highest quality of medical care. Show less