Administrative Assistant Claims Adjuster
Resume:
Natalia Mack
McKinney, TX *****
****************@*****.***
Willing to relocate to: Remote
Authorized to work in the US for any employer
Work Experience
PIP Claims Adjuster
State Farm-Richardson, TX
August 2023 to Present
Investigate, negotiate, and conclude assigned Personal Injury Protection claims. Process claims, document files, and ensure compliance with regulations. Communicate professionally with insureds. Evaluate coverage, liability, damages, and settles claims. • ** Mediate between policy holders, witnesses, and claimants for claims details. • ** Identify and report potentially suspicious claims. • ** Attend depositions, arbitrations, trials and other legal proceedings. A/R Collections Specialist
Fresenius Medical Care-Plano, TX
August 2018 to August 2023
Ability to effectively communicate via phone and email ensuring that all Administrative Assistant duties are completed accurately and delivered with high quality and in a timely manner. May direct and lead the work of others. Review patient accounts to identify delinquent and due accounts. Follow collection procedures to receive the payments. Utilize computer software to process, print and e-mail patient medical bills. Maintain a database of client accounts and billing information. Contact insurance companies for claim processing and reimbursements.
• Responded to emails/faxes
• Managed day-to-day operations of Billing Office
• General clerical support duties including faxing Account Resolution Specialist
Conifer Health Solutions/Wellstar Health Systems-Frisco, TX October 2017 to August 2018
Maintains exceptional service and integrity with customers and client accounts through accurate, timely, relevant, and quality work efforts of all inventory assigned to the self-pay billing revenue cycle and call center.
Drives inquiries from customers and clients towards resolution which includes the identification of the appropriate source of payment or assistance program. Records and maintains complete and accurate documentation of all activity performed on appropriate medium.
Informs management of operational issues impeding performance or customer satisfaction including but not limited to those impacting the customer, client, or the company. Patient Account Representative
Conifer Health Solutions-Frisco, TX
March 2017 to September 2017
Organized and analytical in all work to avoid mistakes Excellent data entry and invoicing skills
Great sales and customer service skills in person or over the phone Understanding of accounting procedures
Exceptional writing skills
Proficient in computer programs related to credit card processing and invoicing Exemplary work ethic and self-motivation needed for a job done completely and done well Customer Service Representative
Cigna-Sherman, TX
September 2016 to February 2017
• Provide necessary information regarding the facility’s services and doctors’ availability
• Obtain necessary patient information such as medical histories and insurance information and ensure that it is properly processed and recorded
• Contact insurance companies to verify coverage and benefits and provide doctors with feedback on coverage and copays
• Assist patients in understanding how their insurance coverage works and calculate and present copays. Billing Consultant
FTGU Medical Consulting-Richardson, TX
December 2015 to August 2016
Responsibilities
Send electronic and paper claims to primary, secondary, tertiary insurances. process payments for patients over the phone.
Follow up on claims every two weeks and verify statuses of claims through insurance and work correspondence received from insurance, also I have knowledge with HCFA claims, Microsoft Excel program
Credit Card Processor
Optum-Richardson, TX
October 2015 to December 2015
Responsibilities
Process credit card payments from United Health Care members. Accomplishments
The impact I had with this company during my time is I'm able to build a relationship with the members. Collections Specialist
West Asset Management-McKinney, TX
December 2013 to October 2015
Locate customers using credit bureau information, background checks, loan documents, and other paperwork or databases.
Utilize computer systems to handle skip tracing.
Inform clients of overdue accounts and amount currently owed. Attempt to collect payment.
Review terms of sale or loan documents.
Ensure all customer information is correct, including phone numbers and addresses. Listen to customer's story and determine if debt can be collected. Set up repayment plans and new terms of sale.
Offer advice or refer customers to debt counselors. Record new commitment to repay debt.
Send statements of delinquencies to credit bureau. Education
High School Diploma
McKinney Boyd High - McKinney, TX
2009 to 2012
Skills
• Call Center (4 years)
• Customer Service
• Payment Posting (3 years)
• Administrative Assistant (3 years)
• Billing (3 years)
• Clerical
• Microsoft Word (8 years)
• Outlook (8 years)
• Organizational Skills
• AR
• Accounts Receivable (3 years)
• Medical Billing (4 years)
• Accounts Payable
• Word (8 years)
• Microsoft Excel
• Microsoft Office
• Data Entry (7 years)
• MS Office
• Phlebotomy (Less than 1 year)
• Microsoft Outlook
• QuickBooks
• Communication skills
• Office experience
• Patient Care
• Medical Office Experience
• Upselling
• Medical billing
• ICD-10
• Medical terminology
• CPT coding
• Medical coding
• ICD coding
Certifications and Licenses
Certified Phlebotomist
April 2018 to Present
Food Handler Certification
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