Resume

Sign in

Claims Assistant

Location:
Santa Ana, CA
Posted:
October 31, 2019

Contact this candidate

Resume:

Linda E. Jones

*** *********, ******, **. *****

949-***-****

Email: adap6n@r.postjobfree.com

OBJECTIVE: To obtain a position effectively utilize expertise, creative talents and commitment to excellence. Desire a position with a challenging and growth- oriented opportunity.

PROFESSINAL EXPERIENCE

Sedgwick CMS

3760 Kilroy Airport Way, Suite 400

Long Beach, Ca. 90806-2456

Claims Assistant - Professional Liability

February 4, 2014 to March 21, 2019

PRIMARY PURPOSE: To provide technical claims support to the Professional Liability claims staff and customer service to claimants, clients and vendors; to perform administrative duties as required.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Sets up new claim files pursuant to department protocol in IVOS system.

Prepares/Print reports per Client and/or Manager's request.

Handles special mailing and delivery requests.

Issue and process Settlement payments and release forms

Processes claim payments, process refunds/overpayments/void checks as appropriate.

Receive, enter and process Attorney legal voucher payments as requested

Receive and process mail and overnight packages

Performs administrative duties as required.

Performs other duties as assigned.

Gallagher Bassett Services, Inc.

27061 Aliso Creek Road

Aliso Viejo, Ca. 92656

Claims Technician- 12/01/06 to 12/31/12 (Lay-Off)

Assist the Claims Representatives in the set up and administration of Auto, Liability and General Liability and Set up of Workers Compensation claims

Set up and enter new claims into claims management system received via UPS, Mail, Fax and through incoming Claims management system Risx- Facs system

Input and review notes/ diaries in claims management system as instructed

Issue and process settlement payments and release forms

Reviews, prepare, create, and/ or send letters, reports and forms, keep case logs by client, process recovery vouchers and live checks

Assist claims representative with telephone calls and claim diaries

Requesting of Wage Statements, Motor Vehicle Reports

Perform miscellaneous administrative and support functions as designated by supervisor.

Linda E. Jones

129 Remington, Irvine, CA. 92620

949-***-****

Email: adap6n@r.postjobfree.com

Pacific Life & Annuity- 04/01/01 to 07/01/05

2300 Main Street, Irvine, Ca 92614

Sr. New Business Specialist (Lay-Off)

Performed a variety of specialized tasks to assist Underwriters and administration of Medical, Dental, Vision and Life Insurance contracts such as Employer Applications, Checks and Enrollment forms

Supported and performed specialized technical skills such as:

Compiled information from brokers, Employers and Applicants and others to prepare packages for Underwriting

Entered census information into system and calculated premiums

Worked with a moderate number of brokers

Handled complex employment packages

Acted as a liaison between underwriters, employers and brokers

Reviewed submitted documents and employer packages to ensure compliance with established regulations, procedures and product requirements

Completed required checklists and worksheets according to policies/procedures

Submitted file for underwriting and reviewed underwriter terms and conditions

Collected conditions from broker and submitted completed file to underwriting

Communicated with underwriters to close files with brokers

Reviewed/ responded to exception reports, audits and quality control reviews

Provided documentation as required

Maintained awareness of all legal regulations related to processing procedures

Performed other related duties as assigned and required.

Software Skills:

PC & Microsoft Office Products ( Word, Outlook, etc.), Windows 08, Lotus Notes, AS400, Solution Suite( Paperless Workstation), SIR, IVOS,

Awards:

Perfect Attendance Award - Pacific Life & Annuity

Reach for the Stars Award - Pacific Life & Annuity

Employee Excellence Award - 2007 & 2010- Gallagher Bassett

REFERENCES UPON REQUEST



Contact this candidate