North Canton, Ohio, United States
Confident and diligent insurance specialist with expertise in healthcare, policy coverages, and sales process. Intelligent and level-headed in evaluating and negotiating complex claims, ensuring compliance and optimizing outcomes for all parties. Experienced in healthcare in diverse settings and operations at multiple levels. Highly professional with a strategic mindset, committed to efficiency, accuracy and customer satisfaction.
-Investigate, evaluate, process auto insurance claims with focus on policy coverage, endorsements and compliance -Analyze medical records, bills, ICD-10 coding, IME’s, and peer reviews -Effectively communicate with claimants, attorneys, and medical providers to expedite the claim process -Identify and investigate potential fraudulent claims or inaccurate billing from medical providers -Conduct thorough and accurate claim file documentation including financial reserves -Handle claims accurately with active insurance laws, legal, and federal regulations -Strong understanding of insurance policies, coverages and exclusions
-High-end client interaction -Customer satisfaction and problem solving -Networking and professionalism -Time management and efficiency -Attention to detail -Collaboration and communication for events
-Completed inpatient and outpatient lab specimen -Maintain accurate patient records and patient privacy regulations -Cross department collaboration with effective communication -Managed and ordered supplies, optimized daily operations to ensure properly workflow and efficiency -Developed knowledge in clinical operations and improvements to short and long term processes
-Completed data input and analytical research for Dr. Ben-Porath in the Psychology department -Focused on personality research and Spinal surgery evaluations collaborated through the Texas Back Institute -Gained experience in statistical analysis and data reporting with detail and compliance -Gathered data to identify trends, predictive insights, and process improvements
MMPI-2 Research Assistant (Minnesota Multiphasic Personality Inventory)