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Medical Insurance

Location:
Tampa, FL
Posted:
April 30, 2016

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Resume:

Jose Hidalgo

**** ******** ******,

Bronx, NY ***52

646-***-****

acuksn@r.postjobfree.com

Education

New York City College of Technology/CUNY, Brooklyn, NY

BTech in Computer Engineering Technology, December 2013

Magna Cum Laude

GPA-3.5

New York City College of Technology/CUNY, Brooklyn, NY

A.A.S. in Electromechanical Engineering Technology, December 2011

With Honors

GPA- 3.6

Experience

American Transit Insurance Company, Brooklyn, NY 03/2015-Present

Property Damage Examiner/No-Fault Data Entry

Process all active claims in a prompt and professional manner.

Follow up on any outstanding accident reports, witnesses and investigation.

Determine liability on vehicle accident including all investigation using New York State guidelines and applicable insurance laws.

Extend a fair and reasonable offer to settle with claimants in writing in accordance with NYS Regulation 64.

Negotiate with claimants, attorneys, body shops and other insurance representatives regarding liability assessment, percentages and damages dispute.

Exhibit accurate decision making abilities and provide sound reasoning for the settlement position taken.

Exhibit professionalism and courtesy when dealing with claimants and other representatives.

Call claimants, attorneys, body shops and brokers to acquire additional information to assist in settling claims.

Answer all calls and return all voice mail messages.

Perform other duties assigned by management to obtain department goals.

Enter medical bills into the company’s No-Fault system when the help is needed.

Send additional verification letters using the company’s No-Fault system to medical providers when missing information is needed to process the bill when the help is needed.

Staples, New York, NY 05/2014-04/2015

Easy Tech Associates/Certified Technician

•Computer Repair Technician.

•Determine and demonstrate understanding of customer's needs.

•Make sales on technology products.

•Perform diagnostics and upgrades on customer's computers.

•Giving customers calls for updates on their computer.

•Providing on-sites to customers when necessary.

•Laptop Repair, Virus Removal, Spyware Removal, Data Recovery, PC Optimization, System Restore,

Wireless Network Setup and Printer Setup

Eveready Insurance Company/ Wollerstein and Futoran, New York, NY 05/2012-10/2014

Claims Examiner/File Clerk/Tech

•Pay and process claims within designated authority level.

•Present clear and concise explanations of New York Workers' Compensation Medical Fee Schedule Rules and Regulations when processing payments and denials.

•Create and send letters to medical providers to indicate missing information needed to process bills.

•Dealt with the incoming mail and scanning it into the company’s network on a day-to-day basis.

•Responsible for distributing files to the lawyers when the legal mail comes in on a day-to-day basis.

•Responsible for refilling files and maintaining an arranged file room.

•Responsible for installing and troubleshooting printers.

•Responsible for troubleshooting computer problems when it comes up.

•Troubleshooting networking problems.

Skills

•Bilingual in English/Spanish.

•Proficient in Microsoft Word, Power Point, Outlook and Excel

•Skilled at Internet research and navigation.

•Programming Languages: C/C++

•Possess excellent communication, organizational and interpersonal skills.

References Available upon request.



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