AARON PECINA
Cullman,AL
Summary
Detail-oriented insurance claims professional specializing in Short-Term Disability claims and benefits. Expertise includes evaluating claims, analyzing medical documentation, and making informed benefit determinations. Proficient in resolving complex issues and fostering clear communication with claimants and medical providers. Bilingual in English and Spanish.
Overview
1
1
Certification
10
10
years of professional experience
Work History
Senior Claim Specialist – Short-Term Disability (STD)
Mutual of Omaha
03.2022 - 10.2026
- Managed [Number] claims from initial review through resolution monthly, ensuring accurate and timely benefit determinations that align with policy provisions.
- Improved claim resolution time by [%] through effective communication and efficient document processing while evaluating and adjudicating Short-Term Disability claims using policy provisions, medical information, and supporting documentation.
- Reviewed medical records and documentation to assess eligibility, restrictions, and limitations, facilitating informed decisions on continued benefits, which enhanced accuracy rates by [%].
- Communicated with claimants, medical providers, employers, and internal partners to resolve claim issues and obtain required information, contributing to overall team success.
- Acted as a resource for claim processes, supported team members by addressing complex claim inquiries, and enhanced overall team knowledge, leading to improved operational efficiency.
Medical Billing Specialist
Zotec Partners
Remote, IN
10.2020 - 03.2022
- Reviewed and processed medical claims, verifying eligibility, benefits, and payments to ensure accurate account information.
- Identified claim errors and refiled rejected claims to support accurate and timely reimbursement.
- Researched CPT and ICD coding discrepancies and worked with internal departments to resolve claim issues.
- Assisted patients with unpaid claims and payment plans, addressing insurance-related questions to enhance understanding and resolution.
Travel Agent / Insurance Claims Specialist
World Travel Holdings
Wilmington, MA
11.2016 - 03.2020
- Guided policyholders through insurance inquiries, claim issues, benefits, and coverage options.
- Recorded customer information accurately and organized records in company systems for easy access.
- Oversaw billing, payment processing, account updates, and administrative tasks to ensure smooth operations.
Education
Associate of Science - Business Administration and Management
Wallace State Community College
Hanceville, ALHigh School Diploma -
Fairview High School
Cullman, ALSkills
Short-Term Disability Claims Claims Adjudication Benefits Determination Medical Documentation Insurance Eligibility & Benefits Claim Processing Compliance Customer Service Case Management Problem Solving Documentation Bilingual English/Spanish
Certification
Licensed Health Insurance Agent
Timeline
Senior Claim Specialist – Short-Term Disability (STD)
Mutual of Omaha
03.2022 - 10.2026
Medical Billing Specialist
Zotec Partners
10.2020 - 03.2022
Travel Agent / Insurance Claims Specialist
World Travel Holdings
11.2016 - 03.2020
Associate of Science - Business Administration and Management
Wallace State Community College
High School Diploma -
Fairview High School