LOUISE HILL

*** ******* ****** ********, ** ***** 347-***-**** ad450y@r.postjobfree.com

OBJECTIVE

Detail-oriented Senior Claims Approver with extensive experience in assessing and approving complex insurance claims seeking to leverage expertise in streamlining processes and ensuring accuracy in claim adjudication.

EXPERIENCE

1996-2021

Senior Claims Approver Emblem Health New York, NY

Reviewed and evaluated complex insurance claims, ensuring adherence to policy guidelines and regulatory requirements.

Develop and implement process improvements to enhance efficiency and accuracy in claim processing.

Provide guidance and mentorship to junior claim staff, assisting in professional development and ensuring consistency in claim adjudication.

Strong listening, problem solving, and negotiating skills.

Excellent oral, written, decision-making and organizational skills.

Analyze documentation and evidence to make informed decisions on claims approvals or denials.

Consistently met project deadlines and exceeded client expectations

EDUCATION

Marketing

Eastern Gateway Community College Steubenville, Ohio June 2021

As a recent graduate with a 3.7 GPA, my primary focus is on gaining practical experience and learning from seasoned professionals.

Certificate of Completion New Technologies NY Graphic and Web Designer Nov. 2023

SKILLS

Extensive knowledge of insurance policies, regulations, and procedures

Strong analytical and decision-making skills

Excellent communication and interpersonal abilities

Attention to detail and ability to work effectively under pressure

Proficiency in claims management software and Microsoft Office Suite

Customer Service

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