KOZETA PRENDI

*** ****** ****** *** **** Park, NY 11040 516-***-**** adbwov@r.postjobfree.com

Highly-qualified and experienced Insurance Claims Representative focused on providing the best customer service possible while upholding all company policies.

KEY SKILLS

Exceptional organizational skills, detail oriented, able to multitask

Tax return Course at H&R Block.

Proficient in Microsoft word, Outlook, Excel.

Ability to learn quickly and obtain new crucial

skills

PROFESSIONAL EXPERIENCE

Maidstone Insurance, Mineola, NY 11501

No-Fault Claims Representative, 09/2001 – Present

Review new files to determine current status of injury claim and to develop a plan of action.

Maintain contact with claimants, providers and attorneys to determine treatment status.

Pay, delay or deny bills submitted by medical providers for services rendered according to NY State fee schedule.

Investigate claims involving potential and suspected fraudulent activities and refer to special investigation unit.

Determine eligibility and coverage.

Substantiate legitimate claims and denied unjustified claims.

Trained other claims staff members on proper handling and evaluation of injury claims.

Identify subrogation and refer to Subrogation Vendor.

Determine exposure, establishes adequate reserves and make timely adjustments as required.

Schedule IME’s and discusses requirements with the providers.

Maintain a pending of personal, complex litigated and non-litigated files.

Utilize approved counsel, establish and maintain control of litigation spending as appropriate for each individual case. Savings Bank Of Tirana, Tirana, Albania

Accounting Supervisor 1996-1999

Manage all daily financial reporting functions related to internal and external reporting.

Oversee the department’s responsibilities for month-end closings.

Review and compile all reported financial data of the holding company and subsidiaries, including monthly Board of Directors packages.

Opened new accounts and assisted customers with balance information and adjustments.

Conducting all interoffice transfers.

EDUCATION

TIRANA UNIVERISTY / BACHELOR OF SCIENCE IN ECONOMICS/FINANCE, ACCOUNTING