Claims Associate Account Specialist

ALISHA MONTAGUE

**** ***** ***, ******, ** *****

720-***-**** *********@*****.***

https://www.linkedin.com/in/alisha-montague-68729b2a/

Professional Profile

Successful Insurance Associate with over 16 years of experience in a wide-range of insurance industry functions. Poised professional with superior communication skills and the ability to establish genuine rapport with colleagues, agents, and clients.

Experience

CONSOVA CORPORATION LAKEWOOD, CO

Manager of Verification Services April 2017-Present

Manage workload distribution to ensure deadlines and service line agreements are met

Supervise 15 employees

Data manipulation and data input to create dependent insurance verification census

Periodic employee reviews for production and quality

Understanding of plan description to execute verification per plan requirements

Knowledge of self-funded and fully funded plan descriptions

Creation and execution of verification communications

Development and implementation of new operating system

Ensure exceptional customer service provided to clients

Client Account Specialist April 2014 –April 2017

Prepare and participate in implementation meetings

Manage dependent eligibility project for client

Execute all weekly project status meetings with clients

Prepare, edit and deliver reports per agreed-upon timeline

Develop and maintain client eligibility workbook for internal auditing team

Review and update all internal and external communications

Ensure goals are met throughout the project

PINNACOL ASSURANCE DENVER, CO

Medical Claims Associate March 2009 – April 2014

Manage non-lost time, medical only claims

Identify and review claims for subrogation

Review and analyze medical records

Review and pay bills associated to claim

Complete claim reviews for weekly staffing

Staff questionable claims with investigator

Adjust reserves to ensure that reserve activities are consistent with corporate policies

Present cases and participate in their discussion at claim committee and association safety meetings

Business Director Assistant April 2006 - March 2009

Make decisions and take action within scope of authority in Business Director’s absence

Set up and maintain paper and electronic filing systems for records, correspondence, and other material

Review and prepare expense reports

Review work done by others to check for correct spelling and grammar; ensure that company format policies are followed and recommend revisions

Compose, type, and distribute meeting notes, routine correspondence, and reports

Maintain scheduling and event calendars

Manage projects or contribute to committee or team work

Arrange conference, meeting, or travel reservations for office personnel

Administrative Assistant June 2001 - April 2006

Data entry

Internal and external customer service

Prepare insurance certificates

Prepare medical files for doctors and legal counsel

Answer telephones and give information to callers, take messages or transfer calls to appropriate individuals

Education

NATIONAL AMERICAN UNIVERSITY DENVER CO Bachelor of Business Administration, Nov. 2012

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