Quality Assurance Claims Processing
Resume:
BA Beatriz Ayala
Phoenix, AZ ***** 602-***-**** ***************@*****.***
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PROFESSIONAL
SUMMARY
Dynamic Claims Manager with a proven track record at SecureCare Dental, enhancing organizational effectiveness and customer satisfaction through streamlined claims resolution and quality assurance. Skilled in claims analysis and team management, demonstrating exceptional teamwork and problem- solving abilities. Achieved significant improvements in claims processing efficiency without compromising accuracy or service quality. SKILLS • Claims analysis
• Claims investigation and research
• Policy interpretation
• Claims auditing
• Claims processing
• Team management
• Quality assurance
• Claims
• Teamwork
WORK HISTORY CLAIMS MANAGER 02/2005 to 11/2013
SecureCare Dental Phoenix, AZ
Collaborated with other departments to improve overall organizational effectiveness in addressing client needs.
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Streamlined communication between adjusters and clients, expediting claim resolution times.
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Enhanced customer satisfaction with timely and accurate claims resolutions.
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Implemented quality assurance measures, monitoring staff performance and providing constructive feedback for continuous improvement efforts.
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Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
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Documented and communicated timely claims information while supporting accurate outcomes.
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Improved claims processing efficiency by implementing streamlined workflow procedures.
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RECEPTIONIST 12/2003 to 02/2005
Western Dental & Orthodontics Chandler, AZ
Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
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Confirmed appointments, communicated with clients, and updated client records.
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• Answered phone promptly and directed incoming calls to correct offices.
• Kept reception area clean and neat to give visitors positive first impression.
• Resolved customer problems and complaints.
Handled cash transactions and maintained sales and payments records accurately.
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Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
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• Responded to inquiries from callers seeking information. Maintained a well-organized reception area with updated materials, contributing to a welcoming environment for visitors.
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• Answered central telephone system and directed calls accordingly. Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
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Demonstrated strong multitasking abilities while managing numerous tasks simultaneously under tight deadlines.
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Handled sensitive information with discretion while maintaining strict confidentiality standards.
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• Managed multiple tasks and met time-sensitive deadlines. EDUCATION Medical Assistant 05/2000
Computer Career Centers, El Paso, TX
High School Diploma General Studies 05/1999
Bel Air High School, El Paso, TX
LANGUAGES Spanish
Native or Bilingual
English
Elementary
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