Medical Customer Service

Dina Becker

*** **** ********** **. *********, PA 18634 US Day Phone: 570-***-**** Evening Phone: 570-***-**** Email: ********@*****.***

Work Experience:

Berkshire Hathaway Guard Insurance 16 South River Street

Wilkes Barre, PA 18703 United States 01/2002 – Present

Complex Claims Representative:

2011 to present -investigates complex Workers' Compensation claims, in multiple states, to include catastrophic and death claims; works closely with defense attorney's, litigating claims for a successful resolution, example: negotiates settlement's with plaintiffs' attorneys, attends hearings via phone, and negotiates deposition fees with plaintiffs' attorneys; reviews complex medical records for approval ofa claim and payment of indemnity and medical benefits afforded to an individual; uses payroll to calculate a rate to be afforded to an individual; provides ongoing communication with external and internal individuals.

2007-2011: Guard Insurance Group, Wilkes-Barre, PA Workers’ Compensation Claims Coordinator of the Early Intervention Unit: coordinated and supervised 7-10 insurance adjusters assuring adjusters’ compliance within twenty-four states; supervised adjusters’ timeframes in indemnity and medical bill payments; approved all wage calculation for each adjuster;trained newly hired adjusters; performed file audits on adjusters’ specific to their annual reviews; collaborate with department manager on issues, and improvements needing to be addressed with adjusters; kept individual adjusters’ caseloads current when they are not available; resolves differences an adjuster may have with an external customer; use of various state regulations and medical knowledge to determine whether a claim should be paid or denied.

2001-2007: Workers’ Compensation Adjuster of both the Medical Only and Early Intervention Unit: Investigation and payment of indemnity benefits, and review of medical records in multiple states throughout the United States; ongoing communication with external and internal individuals.

Becker, Dina M. Resume

1998-2001: Med Staff Traveling Company, Philadelphia, Pa Traveling Surgical Technologist: Six Assignments throughout the United States, to include: Duke University Medical Center, Durham, NC; Saint Francis Hospital, Wilmington, DE; A.I. DuPont Children’s Hospital, Wilmington, DE;Lenox Hill Hospital, New York City, NY;Saint Barnabas Burn Center, Livingston, NJ and Summit Hospital, Summit NJ

Assisting surgeon’s in a variety of medical/surgical specialties

Education:

Luzerne County Community College Nanticoke, PA United States Associate's Degree 03/2007

GPA: 3.5 of a maximum 4.0 Credits Earned: 60 Semester hours Major: Surgical Technology Relevant Coursework, Licenses and Certifications: Surgical Room Technology I, Basic Surgical Interventions, Complex Surgical Interventions, Advanced Topics for Surgical Technology, Surgical Pathology, Pharmacology for Surgical Technology, Applied Microbiology/Infection Control Practices and Procedures for Health, Anatomy & Physiology, Sociology, Chemistry I & II & Algebra.

Perform continuing education, in order to keep licenses validto adjust Workers’ Compensation Claims.

Job Related Training: Please refer to job experience

Qualification Summary:

Exceptional organizational skills Excellent communication skills Superior customer service skills with both internal and external individuals Welcomes ongoing change and challenges Task and detail oriented

Interacts professionally with co-workers at all levels Excellent time-management skills

Ability to work under minimal supervision Ability to work within a high stress environment Excellent computer skills

References available upon request.

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