Aisha Palmares
Tampa,FL
Summary
Dynamic professional with extensive experience at Progressive, excelling in claims processing and customer service. Proven problem-solver with strong interpersonal skills, enhancing team productivity and workflow efficiency. Adept at documentation and reporting, I consistently delivered exceptional results while managing inventory effectively. Committed to fostering collaboration and driving success in fast-paced environments. Energetic professional successful at motivating and building positive team dynamics to accomplish aggressive goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success. Strategic professional in business operations known for high productivity and efficiency in task completion. Specialize in process optimization, project management, and data analysis, ensuring streamlined workflows and enhanced operational efficacy. Excel in communication, problem-solving, and leadership, leveraging these soft skills to drive team success and achieve organizational goals.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Qualified Superviosr
Progressive
Tampa, FL
12.2023 - Current
- Monitored employee productivity levels on a regular basis to identify areas of improvement.
- Complied with company policies, objectives and communication goals.
- Calculated and authorized payment of claims within designated authority level.
- Maintained positive working relationship with fellow staff and management.
- Supervised and monitored daily activities of the medical claims department staff to ensure accurate and timely processing of all claims.
- Identified potential areas where workflow improvements could be made within the department in order to increase productivity levels.
- Monitored employee productivity to provide constructive feedback and coaching.
- Set specific goals for projects to measure progress and evaluate end results.
PIP Adjuster (Lvl 39)
Progressive
Tampa, FL
01.2022 - Current
- Demonstrated excellent communication skills when interacting with customers.
- Calculated and authorized payment of claims within designated authority level.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Reviewed medical records to determine the appropriateness of services rendered and billed by healthcare providers.
- Documented all decisions made on claims in accordance with established guidelines.
- Gathered and documented evidence to support both the coverage afforded and the denials.
- Analyzed medical claims for accuracy, completeness, and compliance with company policies and procedures.
- Managed inventory and keeping my ratio at 1:1
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Identified needs of customers promptly and efficiently.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
National Medical Unit
Progressive
Tampa, FL
11.2018 - 01.2021
- Analyzed accident reports, medical records and other documents to determine the extent of coverage.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Accurately processed large volume of medical claims every shift.
- Maintained accurate records of all activities related to claim adjustments.
- Responded promptly to inquiries from members about their claim status.
- Analyzed medical claims for accuracy, completeness, and compliance with company policies and procedures.
- Reviewed medical records to determine the appropriateness of services rendered and billed by healthcare providers.
- Worked with cross-functional teams to achieve goals.
- Assisted with customer requests and answered questions to improve satisfaction.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Senior Academic Advisor
Everest University
Tampa, FL
01.2010 - 11.2018
- Held regular office hours to provide one-on-one support for students who needed additional assistance with their studies.
- Advised student organizations related to academic interests and professional development.
- Attended conferences, seminars and professional development sessions related to higher education advising practices.
- Maintained accurate and complete student records required by laws, district policies and administrative regulations.
- Advised students on academic course selection to ensure alignment with degree requirements.
- Provided academic advisement to students on degree requirements, course selection and university policies.
- Referred to tests, records and interviews to evaluate students' or individuals' abilities and interests.
- Advised students on course selection, pathways and career options.
- Reviewed and interpreted placement and other standardized test scores.
- Prepared students for later educational experiences by encouraging to explore learning opportunities and persevere with challenging tasks.
- Monitored student academic progress and provided interventions to support success.
- Coordinated registration procedures at the beginning of each semester, ensuring that all paperwork was completed accurately.
- Evaluated transfer credits from other institutions and determined how they would apply towards a degree program.
- Utilized academic advising technologies to manage student appointments and records.
- Presented students with information and resources to promote academic progress and empowered students to take responsibility for academic success.
- Created individualized academic plans for each student to help them reach their educational goals.
- Established and supervised peer-counseling and peer-tutoring programs.
Education
Bachelor of Arts - Communication
University of South Florida
Tampa, FL06-2006
Skills
- Interpersonal skills
- Documentation and reporting
- Problem-solving abilities
- Inventory management
- Teamwork
- Organizational skills
- Multitasking
Certification
- Licensed adjuster
Languages
English
Professional
Spanish
Professional
Accomplishments
- Progressive chose me to work with Summer interns
- Becoming a mentor shortly after joining the organization
Affiliations
- I enjoy both word and number puzzles
- Learning about cultures
- Family time
- Traveling
References
References available upon request.
Timeline
Qualified Superviosr
Progressive
12.2023 - Current
PIP Adjuster (Lvl 39)
Progressive
01.2022 - Current
National Medical Unit
Progressive
11.2018 - 01.2021
Senior Academic Advisor
Everest University
01.2010 - 11.2018
Bachelor of Arts - Communication
University of South Florida
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