DOLORES PALUMBO

*** ***** *** ****** ********** CA 90640 323-***-**** ac601m@r.postjobfree.com

OBJECTIVE

To obtain a position as a claims assistant in an insurance company which would utilize my growing claims knowledge and provides opportunities to expand my skills in the Workers’ Compensation industry and/or Health Care Industry..

SKILLS PROFILE

-Fluent in Spanish both Spoken and Written

-Proficient in Microsoft Office Suite

EMPLOYMENT HISTORY

Benefits Advisor, Aflac 09/05/2017-03/30/2018

Pasadena, CA

-An independent agent representing Aflac

Claims Assistant, Amtrust North America

10/1/2015 9/5/2017

Covina, CA

-Issue benefit notices /forms and set reminders for decision dates (PD delay decision due, claim delay notice decision due, etc.).

-Issue benefit payments and set-up pay diaries for any subsequent payments due.

-2 point contacts (medical provider/employer).

-Contact medical providers and/or employers for medical/employment status.

-Issue bill objections to providers.

-Issue payment for in-house bills.

-Set up medical appointments, send appointment notice and advanced mileage.

-Create and submit EAMS documents to WCAB.

-Complete and submit litigation referral.

-Copy work (IMR, Subpoena of Records, etc.)

-Medical treatment denials.

-Check issues (overnight mailing, stop pay request, bounced/returned check research).

-Vendor issues (W9 request and follow up, address change, add new vendor).

Claims Assistant, Springfield Insurance Company

2005-2015

Covina, CA

-Provides clerical support to multiple claims adjusters and performs related work as required.

-Set up indemnity/litigated and medical only claims.

-Initiate 3 point contact.

-Process all benefit notices in a timely manner.

-Issue disability payments timely ensuring no penalties due to late payments.

-Review and process payments from invoices received from vendors, doctors, applicant and defense attorney’s.

-Research bill calls and answer all questions and/or resolve issue by processing payment.

-Ensure proper closure of files when applicable.

-Interface with doctor and attorney offices, employers and claimants.

-Provide back-up assistance to mail room clerk: open, sort, date stamp and index all incoming mail. Process out -going mail.

Accounting Clerk, Unified Grocers Insurance Services

2004-2005

Covina, CA

-Posting of cash receipts (identify checks, post payments, small balance w/o and moving credits to open balances).

-Checks Log.

-UGIS deposit.

-Printing/mailing of dunning letters and statements.

-Printing/mailing broker statements.

-Reprinting of invoices and statements

-Filing accounts for collections with Charter Adjustment Corporations.

-Cancellation of policies for non-payment.

-Reinstatement of policies upon receipt of payment if prior to cancellation effective date. If no payment, forward to underwriting department.

Accounting Clerk, Russell and Miller

2004-2004

Santa Fe Springs, CA

-Collections (A/R, high volume calls to customers).

-Daily invoice printing and mailing.

-Correspondence (customers, collection agencies).

-Order release of shipment to customers (daily, expedite, cumulative).

-D&B placement (filing collection claims with letter writing service).

-Reconciling customer accounts.

Medical Biller/Collector, Beverly Hills Orthopedic Group

2001-2003

Beverly Hills, CA

-Billing and collections for 3 orthopedic surgeons.

-Review and mailing of patient statements.

-Insurance and patient correspondence.

-Electronic submission of claims.

Medical Collector/ City of Hope

2000-2001

W. Los Angeles, CA

-Medicare collections.

-Review and mailing of patient statements.

Claims Processing and Auditing, Medical Pathways

2000-2000

Cerritos, CA

-Process encounter / senior claims.

-Locating, comparing and coding problem / error claims utilizing three software programs.

Business Office Manager, Elmcrest Convalescent Hospital

1998-1999

El Monte, CA

-Medical biller / collector (Medicare, Medi-Cal, HMO & Private Ins.).

-Maintenance of daily / monthly census reports.

-Prep. & submittal of long term care Medi-Cal applications.

-Posting of all cash receipts (A/R).

-Management of patient trust funds.

-Management of patient trust / facility petty cash and bank accounts

Operations Manager, Bilingual Psychological Associates

1991-1998

Montebello, CA

-Front and back office management.

-Medical biller/collector (HMO, Medi-cal, Medicare & Private Insurance).

-Accounts receivable/accounts payable.

-Management of HMO contracts and authorizations.

Education

California State University, Long Beach CA

BS, Business Management - 1998

References

Available Upon Request

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