Mionne Renee Love

**** ******* **** ***** ******, GA 30518

ad2jya@r.postjobfree.com 470-***-****

Work Experience

Chubb /Esis November 8, 2021 to Present

Claims Assistant Esis/Propriety Auditor

Registrations, Management of mail including claim submissions and emails to the department email account

Run daily reports, ensuring required action is taken and proper filing is done, Review, update and submit month end reports accurately and timely

Attend to inquiries and feedback from customers, brokers, or service providers

Track and attest to the daily results, communicate errors to individuals making payments, ensure corrections are made, verify the corrections and report findings to management

Send First Notice of Loss to appropriate claim adjuster AGL or Workers Compensation

Performs Daily Propriety Audits to ensure the legitimacy, accuracy and proper payment authority for Claim Payments made, pull and save audits

State Farm Insurance - Dunwoody, GA March 2020 to February 2021

Underwriting Assistant

Production in Business Fire Lines assisting Underwriters with applications

Prepare proposals for new business, Renewal of existing business

Prepare Binders for Special Risk Accounts

Manage relationships and ensure quality customer service with agents while providing quotes

Review renewal & new business submissions for completeness. Reach out to broker for missing information

Review policies upon receipt for accuracy, submit corrections and ensure policy delivery to brokers

Send renewal letters to brokers for upcoming accounts, request policy numbers, properly document all files within established due dates

Handles multiple computer applications while maintaining quality records team environment

Knows where to find answers and serves as a technical and procedural resource to assist in resolving policy and/or policyholder questions

AmTrust Financial Group - Alpharetta, GA May 2017 to June 2019

Claim Clerk Indexer

• Verify name, claim number and policy number on documentation

• Route correspondence of service adjuster in accordance of service standards

• Attach certified receipts, Priority mail, and Workers Compensation Board to correct claim

• Audit first Reports by state and department upload and route to adjuster in a timely manner

• Communicate and assist adjusters with obtaining state forms, correspondence for servicing

• Assist other teams with any projects as assigned by manager

United Health Group - Alpharetta, GA June 2013 to May 2017

Clinical Coordinator/Prior Authorization/Data Provider Loader

Process Prior Authorization request according to Medicare guideline

Determine benefits and eligibility information

Authorize for treatment, verify appropriate ICD-10 and CPT coding

Contact providers to obtain procedure codes and clinical notes when needed

Determine if clinical information meets state requirements for coverage

Review and document clinical information before sending complex cases to Nurse or Medical Director

Communicate status inquiries from providers and members for authorizations

Provide verbal and written decisions to members and provider

CCS Medical - Suwanee, GA October 2008 to August 2011

New Customer Enrollment

• Responsible for contacting potential patients to sign on to the medical program, assess patients' needs and coordinate with physicians' orders and insurance plans

• Assists with customer service-related functions to grow business and patient relations and follow all Medicare, Medicaid and private insurance regulations and requirements

• Evaluates patient insurance coverage, obtain Prior Authorizations for supplies

• Determine if selected products are appropriate based on patient need and insurance benefits

• Compile and review patient medical charts, ensure documentation is received in accordance with carrier regulations, legal guidelines

• Experience in the utilization of ICD-9 codes and CPT diagnosis codes

Education

Early Childhood Education

Brenau University - Gainesville, GA May 2001 to December 2002

Columbus State University - Columbus, GA September 1996 to March 1998

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