Experienced Claims & Patient Scheduling Specialist
Resume:
Rebecca Temple
Buckeye, AZ ***26
Ph: 602-***-****
Email: ******.*********@*****.***
Objective
Highly motivated, dedicated, hard worker with 20+ years of experience looking to work in a fast paced environment with potential to learn and grow within the company. Employment Background
Claim Associate
State Farm Insurance 02/19/2024-present
Delivered remarkable customer experience throughout the reporting and handling of lower complexity claims, identifying and ensuring prompt resolution of claims within scope of authority and segment criteria.
Investigated, evaluated, and settled auto claims within the scope of Auto ILR to include verification of coverage, legal liability, and extent of property damage, which may require contact by telephone, email, correspondence, or other electronic media.
Applied knowledge of policies procedures, laws, statutes, and insurance regulations when determining escalation criteria.
Received and processed claim information and communicated with internal and external customers via phone and other communication channels.
Worked in a team environment to handle and investigate low complexity/high volume work in a call center environment.
Patient Advocate
MedRisk 6/10/2019-February 2024
Make outbound calls to schedule patients in a timely manner to ensure that internal and external metrics are met.
Meet Department goals for Quality and Quantity of work input.
Complete special projects or tasks as assigned by the supervisor.
Work on cases that required investigation for missing information that is necessary to schedule patients for their initial evaluations.
Manage multiple claims at one time from a compliance and clinical perspective.
Manage a report of compliance, date range approvals and extension tasks within strict timelines
Obtain and review all treatment documentation per case.
Review clinical documentation to ensure the patient’s treatment is on course and the case is within clinical guidelines and/or following the adjuster’s specific direction. Rebecca Temple
22529 W Mohave St
Buckeye, AZ 85326
Ph: 602-***-****
Email: ******.*********@*****.***
Properly transfer all case related data to database, organize related documents efficiently and provide well-written documentation to ensure consistent communication across departments.
Build approachable, professional relationship with referring customers.
Effectively work with specific claims offices to ensure they are receiving the appropriate level of service in compliance with our turnaround times and objectives.
Research and comply with client specific workflows, become familiar with the client’s unique needs and respond appropriately.
Effectively document any changes to client specific workflows to ensure the process is managed correctly.
Youth Support Specialist
Bethesda Lutheran Services 2/2016-8/2018
Conducted individual and group counselling sessions with youth including coping skills, anger management, character development, educational, recreational, and therapeutic.
Coordinate day to day routines, developed weekly therapeutic tasks, and followed clinical schedule.
Supervising, creating progress notes, provided educational support, assisted with reports, treatment plans, and discharge summaries.
Managed medications according to residential policy and procedure.
Attended treatment review, team meetings, provided verbal and written documentations for court hearings.
Appointment Coordinator
Rainsoft All American Water Treatment 10/2013-2/2016
Prescreen clients for services
Scheduled clients for services, maintenance, and installation
Coordinate and dispatch installers and sales people
Coordinate and work events, set up store displays, and promote services
Maintain maintenance data base and filing
Medical Secretary
Saint Vincent Health Systems/Allegheny Health network 204-2013 Rebecca Temple
22529 W Mohave St
Buckeye, AZ 85326
Ph: 602-***-****
Email: ******.*********@*****.***
Skills
Highly developed problem-solving, decision-making and relationship building skills
Strong verbal and written communication skills
Strong organizational, time management, and administrative skills
Impeccable customer service skills
Ability to multi task in a fast paced environment and to work independently
Self-motivated
Strong work ethic
Detail oriented, time management and solid organizational skills
Solid MS Word, Excel Outlook, and Salesforce experience
Strong data entry skills
Education
Great Lakes Institute of Technology 2003
Medical Secretary Diploma
State Farm Insurance
Adjusters License
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