ALISHIA K. JOHNSON
New glarus,Wisconsin
Summary
Pet insurance claims adjuster with hands-on experience adjudicating claims, reviewing invoices and medical notes, and confirming coverage details. Supports accurate reimbursements, resolves policy questions, and coordinates with veterinary offices to keep claims moving efficiently and in line with compliance guidelines.
Overview
1
1
Certification
19
19
years of professional experience
Work History
Pet Processor Claims Adjuster
Wagmo Pet Insurance
New York , NY
06.2024 - Current
- Processed Wagmo pet insurance claims and reviewed supporting veterinary documentation.
- Reviewed invoices, receipts, and medical notes for claim accuracy.
- Collaborated with veterinary offices to ensure accuracy of treatment and billing details for claims processing.
- Assisted members with inquiries regarding benefits, reimbursements, and policy status to enhance customer satisfaction.
- Escalated complex claim issues to supervisors and support teams.
- Maintained confidential pet insurance records and compliance documentation.
- Ensured compliance with all applicable regulations, laws, and guidelines.
- Organized and filed documents to maintain accurate records. to maintain records and files.
PET INSURANCE CLAIMS PROCESSOR
BIVVY PET INSURANCE, CUNA MUTUAL GROUP(TRUSTAGE)
MADISON, WI
03.2020 - 03.2024
- Processed and adjudicated pet insurance claims, ensuring accurate and timely resolution for clients.
- Researched and analyzed veterinary medical records to determine coverage eligibility and conditions.
- Communicated effectively with veterinary clinics to retrieve medical records, enhancing claims processing efficiency.
- Experience with clinical veterinary & medical terminology. Able to work independently Input veterinary medical records with appropriate conditions and accurate coverage determinations based on analysis of the records.
- 5 years of experience in a Veterinary Clinic setting.
- Wisconsin License in Property, Casualty and life Insurance as an Intermediary Individual.
- Managed processes during company acquisition
- Executed tasks in a remote work environment
CUSTOMER SERVICE REPRESENTATIVE (LICENSED INSURANCE AGENT)
AMERICAN FAMILY INSURANCE AGENCY IN MCFARLAND, WI ANDREW PEART AGENCY
MCFARLAND, WI
07.2012 - 03.2020
- Sell a variety of insurance products to businesses and individuals.
- Sold auto, homeowners, and life insurance to new customers and upgraded policies for established customers.
- Customize insurance programs to suit individual customers, often covering a variety of risks.
- Consult with customers to evaluate needs and determine best options.
- Explain features of policies and both advantages and disadvantages of various policies.
- Counsel customers on options for service and coverage.
- Upgraded service plans and presented additional coverage options to enhance customer value.
- Answer any questions or concerns policyholders have with their insurance claims.
- Responded to service inquiries and escalated complex issues to ensure customer satisfaction.
- Resolved customer conflicts and concerns, leading to improved satisfaction and loyalty.
ADMINISTRATIVE SUPPORT/RECEPTIONIST
OREGON VETERINARY CLINIC
OREGON, WI
10.2007 - 05.2012
- Welcomed customers upon arrival, offering assistance and relevant information to enhance their experience.
- Answered calls and scheduled patient appointments at Oregon Veterinary Clinic.
- Greeted clients and checked in pets for veterinary visits.
- Verified client information and updated medical records at front desk.
Education
High School Diploma -
Belleville High School
Belleville, WI05-1998
Skills
- Claims processing
- Veterinary claims analysis
- Claim documentation
- Policy review
- Insurance compliance
- Customer service
- Detail-oriented
- Claims processing
Custom
- ALISHIA K. JOHNSON
- 506 3rd Ave. Apt #1, New Glarus WI 53574 608-636-3362
- Summary of Qualifications
- Alishia.partylite@gmail.com
- Motivated Pet Insurance claims processor and experienced customer service Representative for over 20 years, with experience in sales, and customer relations. Proven and contribute to company success. Over 6 years Veterinary Clinic experience or similar medical background, procedures and terminology. Reliable and driven, with strong time management and prioritization abilities.
- MARCH 2020 - MARCH 2024 (COMPANY WAS SOLD)
- PET INSURANCE CLAIMS PROCESSOR, BIVVY PET INSURANCE, CUNA MUTUAL GROUP(TRUSTAGE), MADISON, WI - (REMOTE - WORKING FROM HOME)
- Processed and adjudicating Pet Insurance claims.
- Experience with clinical veterinary & medical terminology. Able to work independently Input veterinary medical records with appropriate conditions and accurate coverage determinations based on analysis of the records
- Detailed oriented with the ability to research
- Excellent oral and written communications skills, Calling and speaking to Veterinary clinics to retrieve medical records daily.
- 5 years of experience in a Veterinary Clinic setting.
- Wisconsin License in Property, Casualty and life Insurance as an Intermediary Individual.
- JULY 2012 MARCH 2020
- CUSTOMER SERVICE REPRESENTATIVE (LICENSED INSURANCE AGENT), AMERICAN FAMILY INSURANCE AGENCY IN MCFARLAND, WI-ANDREW PEART AGENCY
- Answer customer telephone calls regarding existing accounts
- Sell a variety of insurance products to businesses and individuals.
- Answer any questions or concerns policy holders have with their insurance claims.
- Explain features of policies and both advantages and disadvantages of various policies.
- Customize insurance programs to suit individual customers, often covering variety of risks. Make requested policy and account changes per customer requests.
- Respond to question and concern about service and escalate calls appropriately.
- Consult with customers to evaluate needs and determine best options.
- Counsel customers on options for service and coverage.
- Upgrade service and offer additional service packages or options.
- Consistently improve customer satisfaction through expert resolution of conflicts, issue, and concerns.
- Sold auto, homeowners, and life insurance to new customers and upgraded policies for established customers.
- Sent reminders of premium payment and notified customers of any rate changes.
- OCTOBER 2007 MAY 2012
- ADMINISTRATIVE SUPPORT/RECEPTIONIST, OREGON VETERINARY CLINIC OREGON, WI
- Greeted customers as they arrived and provided required information.
Certification
- State of Wisconsin Property, Life and Casualty Insurance License
- Florida Adjuster License
Timeline
Pet Processor Claims Adjuster
Wagmo Pet Insurance
06.2024 - Current
PET INSURANCE CLAIMS PROCESSOR
BIVVY PET INSURANCE, CUNA MUTUAL GROUP(TRUSTAGE)
03.2020 - 03.2024
CUSTOMER SERVICE REPRESENTATIVE (LICENSED INSURANCE AGENT)
AMERICAN FAMILY INSURANCE AGENCY IN MCFARLAND, WI ANDREW PEART AGENCY
07.2012 - 03.2020
ADMINISTRATIVE SUPPORT/RECEPTIONIST
OREGON VETERINARY CLINIC
10.2007 - 05.2012
High School Diploma -
Belleville High School