Claims Processor Adjuster
Resume:
ANGELIQUE
COOPER
************@*****.***
San Antonio, Texas 78247
Talented Manager with expert team leadership, planning and organizational skills built during successful career. Smoothly equip employees to independently handle daily functions and meet customer needs. Diligent trainer and mentor with exceptional management abilities and results- driven approach.
PROFESSIONAL SUMMARY
Allcat Claims Service - Auto Total Loss Adjuster
San Antonio, TX • 02/2022 - Current
Allcat Claims Service - Property Claims Adjuster
San Antonio, TX • 02/2022 - Current
WORK HISTORY
• Issued payouts to claimants.
• Documented all findings
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
•
Carried out day-day-day duties accurately and
efficiently.
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Demonstrated respect, friendliness and willingness to help wherever needed.
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Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.
•
Carefully reviewed claim information to verify accuracy and avert fraudulent claims.
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Examined claims forms and other records to determine insurance coverage.
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Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
•
Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
•
• Exercised proper judgment and decision making to SKILLS
Employee Coaching and
Motivation
•
Business Management
Principles
•
Scheduling and
Coordinating
•
• Quality Standards
Administration and
Reporting
•
Performance Tracking and
Evaluations
•
Managing Operations and
Efficiency
•
• Customer Service
Hueneme High School
Oxnard, CA • 06/1991
High School Diploma
EDUCATION
WellMed Medical Management - United Health Group - Sr. Claims Examiner Manager
San Antonio, TX • 01/2019 - 02/2022
United Healthcare - C & S Claims Processor Manager San Antonio, TX • 03/2017 - 01/2019
analyze over fifty claims per week.
Conducted day-to-day administrative tasks to maintain information files and process paperwork.
•
Examined claims forms and other records to determine insurance coverage.
•
Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
•
Accomplished multiple tasks within established
timeframes.
•
Onboarded new employees with training and new hire documentation.
•
Maximized performance by monitoring daily activities and mentoring team members.
•
Established and updated work schedules to account for changing staff levels and expected workloads.
•
Delivered feedback to decision-makers regarding
employee performance and training needs.
•
• Approved regular payroll submissions for employees. Prepared variety of different written communications, reports and documents.
•
• Carried out day-to-day duties accurately and efficiently. Demonstrated respect, friendliness and willingness to help wherever needed.
•
Exceeded goals through effective task prioritization and great work ethic.
•
Collaborated with team members to achieve target
results.
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Developed and maintained successful working
relationships with team members.
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Worked with team members to provide operational
system support.
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Contributed ideas and suggestions in team meetings and delivered updates on deadlines, designs and
enhancements.
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• Estimated work hours and tracked progress
United Healthcare Group - UHC- E & I Operation S Health Advisor Manager
San Antonio, TX • 03/2012 - 02/2017
Accomplished multiple tasks within established
timeframes.
•
Onboarded new employees with training and new hire documentation.
•
Cross-trained existing employees to maximize team
agility and performance.
•
Delivered feedback to decision-makers regarding
employee performance and training needs.
•
• Approved regular payroll submissions for employees. Raised performance in areas of claims processing, time management and operations by identifying and targeting areas in need of improvement.
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Propelled continuous improvements and strategically capitalized on current busines trends.
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Prepared and recommended long-range plans for
development of department personnel.
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Developed and updated policies and procedures,
maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
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Fostered excellence by example by "setting pace" and being hands on mentor to team members.
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Direct day-to-day administrative and operational
functions for 18 team members, providing guidance and leadership to over 100 employees across more than 18 departments.
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Motivated and supervised 100 customer representatives and mangers in delivering quality customer service.
•
Onboarded new employees with training and new hire documentation.
•
Maximized performance by monitoring daily activities and mentoring team members.
•
Accomplished multiple tasks within established
timeframes.
•
Established and updated work schedules to account for changing staff levels and expected workloads.
•
Delivered feedback to decision-makers regarding
employee performance and training needs.
•
• Approved regular payroll submissions for employees.
Contact this candidate