Adriana De La Torre

· Complete a highly detailed investigation on each claim in a timely manner

· Trained on Baylor Processing

· Worked Baylor Pay & Pursue Log

· Trained on Student Health Processing

· Trained on Prompt Pay Processing

· Federal Employee Program (FEP) Access

· Work priority lists from Excel Spreadsheets

· Complete highly detailed investigations on high priority claims

· Collaborated with internal departments to monitor and ensure compliance with Prompt Pay regulations

· Conducted research and analysis to identify potential issues and evaluate effectiveness of program

· Provided support and guidance to staff on Prompt Pay regulations and requirements

· Complete a highly detailed investigation on each claim in a timely manner

· Trained on Baylor Processing

· Worked Baylor Pay & Pursue Log

· Trained on Student Health Processing

· Trained on Prompt Pay Processing

· Federal Employee Program (FEP) Access

· Assisted Divisional Testing Unit November 2013-March 2014

· Assisted Retail with Advanced Check Process June 2014-September 2014

· Assisted San Angelo with Advanced Check Process July 2014-October 2014

· Assisted with Production Verification January 2017-February 2017

· Collaborating with Fuzzy Math with developing Claims UI May2018-Current

· Effectively reviewed and processed insurance claims in a timely manner

· Verified accuracy of insurance claims to ensure compliance with company policy

· Researched and resolved problems with denied or incomplete insurance claims

· Handled inbound calls from customers to provide them with requested information

· Maintained an average of 90% accuracy in all customer data

· Developed and managed customer relations by providing exceptional customer service

· Utilized problem solving skills to answer customer inquiries

· Maintained timely and accurate logs for each call

· Assisted customers in checking out at the register with a friendly and helpful attitude

· Demonstrated excellent customer service skills by efficiently handling customer queries and complaints

· Accurately calculated discounts and applied them to customer orders

· Processed payments including cash, check, and credit/debit card

· Utilized point of sale system to correctly complete transactions

· Regularly restocked shelves to ensure adequate supplies

· Ensured that all safety regulations were followed