Insurance Specialist Claims Processor

IF

OBJECTIVE

Highly accomplished Administrative Professional with extensive experience with insurance billing and accuracy of valuable data within a fast-paced environment. Demonstrates success coordinating with cross-functional teams.

Key strengths include highly organized, detail-orientated, skilled in directing teams in delivering exceptional service, excellent communication, critical thinking, customer service skills, problem-solving, documentation, and record-keeping. Time and management skills allow for deadline-oriented work on multiple projects simultaneously, with outstanding results. Seeking to support the organization’s missions and objectives.

SKILLS

Critical thinking

Judgment and Decision Making

Time Management

Excellent Communication

Microsoft Office

ISOLA FREDERICK

INSURANCE SPECIALIST

**************@*****.***

EXPERIENCE

CERTIFIED PROFESSIONAL SERVICE REPRESTATIVE • STATE FARM INSURANCE • DATES FROM –08/2021 TO PRESENT

Managing large number of inbound calls in a timely manner

Provides supports to agents

Processing customer payments accurately and timely

Assists with handling any inbound and outbound mail received in the office

Identifying customers’ needs to route the customer to the appropriate point of contact

Proficient in researching documents

Engaging in active listening with callers, confirming or clarifying information and diffusing any customers concerns, as needed.

Verbal and written communication skills to effectively work with all levels of management, other departments, and outside contractors/vendors

Building sustainable relationships and engage customers

Keep records of all customer requests and/or interactions in our policy management system

IMAGING TECHNICIAN • STATE FARM INSURANCE • DATES FROM –09/2005 - 09/2020 TO PRESENT

Performed document prepping, scanning, data entry, and quality control tasks for the Enterprise Imaging Unit to provide document images to or for Enterprise Imaging customers

Provided image processing for business partners

Performed timely and in-depth research on unidentified front-end image mail to determine proper workflow disposition

Knowledgeable of imaging equipment operation and maintenance

Performed routine, repetitive work in a fast-paced environment

Proficient in researching documents

Customer service skills

Verbal and written communication skills to effectively work with all levels of management, other departments, and outside contractors/vendors

CLAIMS PROCESSOR•STATE FARM INSURANCE • DATES FROM – 12/2014 TO 09/2020

Researched claims problems to resolve edits and deferrals.

Verified claims acceptance using patient benefit plans, acquiring authorization where required.

Reprocessed, adjusted, and recouped claims to correct processing errors.

Processed claims according to established quality and production standards to handle demand with high accuracy.

Obtained supporting documentation from the claimants and their representatives and transferred it to vendor partners.

Entered details of medical bills, communications, and other records to help the examiners review detailed histories.

EDUCATION

CERTIFIED NURSING ASSISTANT • AUGUST 2004 • LINCOLN LAND COMMUNITY COLLEGE

LICENSE

CSR 440 • AUGUST 2021 • CENTRAL INSURANCE SCHOOL

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