Insurance Claims Examiner Resume

OBJECTIVE:

To obtain a position that utilizes my experience and education with a company that offers opportunity for professional growth and advancement.

SUMMARY:

Ability to learn very quickly
Interpersonal Communication Skills
Manage stress/performance under pressure
Strong organizational skills
Team Oriented
Privacy Awareness

PROFESSIONAL SKILL:

Property & Casualty Licensed Claims Adjuster
Leadership/Management
Microsoft Office Certified
Computer Literacy
Project Management
Process Improvement
Customer Service/Care
Data Entry
Billing Reports
Policy & Procedure writing skills
Problem Solving & Analytical skills
Admin/Office skills
Networking

COMPUTER EXPERTISE:

Word Processing: Microsoft 97, 2003, 2007, 2010 & 2013 Word Perfect 10

Spreadsheets: Microsoft Excel 7.0

Database Management: Microsoft SharePoint and Access 97, 2003, 2007 & 2010

Presentation: PowerPoint

Accounting: QuickBooks

Operating Environment: Windows, Internet, DOS

Typing WPM: 50+ words per minute LPS/Newtrak Client contact system, Lexis Skiptrace Borrower information system, Pacer/district pacer Bankruptcy Programs

Chase Systems: Real Quest, ACLS, CLW, OPUS, ATOM, CMTS, RECS, CCWLending Portal (MSP). MAC, MERS Online, Epic, Winn, Pots, Ernst, Fastrieve, Lisa, Sparta, Ivault, Image web, Acris, Netro, Case Manager, Time & Attendance

PROFESSIONAL WORK EXPERIENCE:

Confidential

Insurance Claims Examiner

Responsibilities:

Examine and process all medical claim types to ensure all guidelines are followed
Evaluate if a company must pay on a claim and how much
Determine whether the members insurance policy covers what is claimed
Ensure that incoming claims are not fraudulent or have been billed more than once
Work with the legal counsel, doctors and nurses when needed
Negotiate settlements and authorize payments to providers

Confidential

Office Supervisor

Responsibilities:

Supervisor over 18 employees making sure that they provide secretarial and administrative support to management and other staff as needed
Calculate and process weekly pay for employees and venders via Quick Books
Train employees how to maintain the day to day office work
Staying organized and being able to Multi - task 100% of the time daily
Use computer software to prepare invoices and financial statements (QuickBooks)
Assist with financial reports as required
Use computer word processing, spreadsheet, and database software to prepare reports, memos, and documents
Direct phone inquiries, voice mail and/or emails to the appropriate staff member
Answer general phone inquiries using a professional and courteous manner
Prepare and sort incoming and outgoing faxes, mail, and courier deliveries
Purchase, receive and store the office supplies ensuring that basic supplies are always available
Code and file material according to the established procedures
Coordinate the maintenance of office equipment
Administer petty cash according to established procedures

Confidential

Team Lead

Responsibilities:

Supervised over 30+ employees at once
Answering calls helping customers with:
Explaining the company’s policy
Payment arrangements
Tracking shipments (lost or in route)
Updating customer accounts
Processed monthly billing and invoicing
The point person for answering departmental requests, distributing and processing emails and calls in a timely manner. (24 to 48 hour timeframe)
Making sure all loans are correctly placed in all servicing systems
Pulling Various MERS reports (Extensive MERS knowledge)

Business Analyst

Confidential

Responsibilities:

Create spreadsheets, graphs and tables for presentations
Monitors the department billing and calculations
Help management with interview process and selection of candidates.
Ability to manage constant changes
Write all of the departments procedures and guidelines
Coordinate with upper management to resolve problems
Ensure there is effective management of any activities
Monitor activities while making sure that the objective and principles are met
Take on accountability for the task at hand

Confidential

Legal Assistant

Responsibilities:

Process Legal claims containing confidential information
Researched title issues and corrected all resulting problems
Calculation of owed/delinquent payments
Contacted and followed up with notaries, mortgagors and clients via phone, fax or email

Confidential

Sr. Operation Specialist

Responsibilities:

Prepare Mortgages to be sent to counties for recording
Examine (proof) Mortgages before the customer receives the documentation
Communication with customers concerning their mortgages
Contact w/ county for needed documentation/ recordings

Confidential

Clerical Assistant

Responsibilities:

Implemented and operated a computerized filing system
Managed all records of incoming and outgoing titles to homes
Opened all Titles on a Confidential System so that they were prepared for further use.
Accurately operated phone lines with extensions
Effectively assisted 3 managers
Maintained this job while attending College full - time

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