WORK EXPERIENCE

Liberty Mutual- Auto Property Damage Specialist

Liberty Lake, Washington

Februarys 2016-Current

Manage clients’ auto accident claim from beginning to end

Set clients up with rental reservations while reviewing coverage

Set appointments with auto shops for clients

Return emails and voicemails addressing concerns

Listen, understand and advised of the clients needed coverage

Determine fault on auto accidents

Keep proper electronic and paper files of claims updated and in order

Re-create auto accidents

Review county codes and statues regarding traffic laws

Coordinate coverage and investigations with other insurance carriers

Premera Blue Cross- Customer Service Associate NAO I-Amazon

Claims and Referral Specialist

May 2013- February 2016

Spokane, Washington

Listen to customer’s issues, and form a solution while updating the file

Effectively explain a member’s insurance benefits

Also explaining how a medical claim processed to benefits

Assist member’s flexible spending account and health savings account

Insure member is aware of all plan requirements

Ensure claims process correctly

Process claims in a timely fashion

Enter referrals from fax folders and emails from Outlook, faxes and calls

Manage referral files, fax folders and email box

Maintain communication with customer service on status of claims and referrals

Complete knowledge of insurances, pre-authorizations, referrals, authorization denials, claims denial codes and reasons, procedure and diagnosis codes, provider relations, provider agreements and contracts, allowed amounts and fee schedules.

Wal-Mart - Customer Service Supervisor

September 2012 – May 2013

Spokane, Valley Washington

Resolve customer complaints regarding sales and service.

Check to ensure the appropriate changes were made to resolve customers' problems

Refer unresolved customer grievances to designated departments for further investigation.

Provide customer service by greeting and assisting customers, and responding to customer inquiries and complaints.

Direct and supervise employees and assign specific duties.

Enforce safety, health, and security rules.

Keep daily records of cash handling.

Preform daily audits on registers.

Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.

Refer unresolved customer grievances to designated departments for further investigation.

Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments

EDUCATION

Apollo College

Degree: Medical Assisting

Skills: Front office Management: Patient check-in, insurance verification, some billing and coding, filing, answering phones.

Back office: X-rays, Provider assisted procedures, small scale lab tests, vitals.

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