Summary
Work History
Education
Skills
Timeline
SalesManager

Amanda Loya

Summary

Detail-oriented Examiner with 5 plus years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process, insurance and collections industry.

Work History

Sales Manager

True Solutions
Covina, CA
09.2018 - 11.2019
  • Grew market penetration and sales figures by leveraging supplier relationships and personally overseeing negotiations resulting in revenue increase.
  • Produced contracts, reports, letters, and proposals for clients.
  • Identified opportunities for growth within territory and collaborated with sales teams to reach sales goal.
  • Maintained relationships with customers and found new ones by identifying needs and offering appropriate services.
  • Handled customer relations issues, enabling quick resolution and client satisfaction.

Claims Examiner III

Medix Staffing Solution - Prospect Medical Systems
Orange, CA
11.2013 - 04.2018
  • Managed large volume of medical claims on daily basis.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
  • Responded to correspondence from insurance companies.
  • Examined claims forms and other records to determine insurance coverage.
  • Paid or denied medical claims based upon established claims processing criteria.
  • Calculated adjustments, premiums, and refunds.
  • Communicated effectively with staff members of operations, finance and clinical departments.

Sales Representative/Debt Collector

Kentwood Law Group
Montclair, CA
07.2012 - 11.2013
  • Worked with collections team to collaboratively reach targets, consistently meeting or exceeding personal quotas
  • Used consultative collections approach to understand customer needs and recommend relevant offerings
  • Operated with high integrity, built trust, and earned sustained credibility with clients
  • Used skip tracing and other techniques to locate debtors
  • Set up drafts and processed immediate payments after conducting thorough research and analysis of account
  • Delivered exceptional customer service on all calls while maintaining calm and professional demeanor in challenging circumstances

Education

Notary Commission / Signing Agent

Notary Learning Center
Ontario, CA
03.2020

Life, Health And Accident Insurance Producer

EXCEL Solutions
04.2019

Skills

  • Health insurance industry knowledge
  • Medical terms and procedure knowledge
  • Thorough insurance claims review and processing
  • Risk management
  • Insurance policy coverage knowledge
  • Benefits review
  • Knowledgeable in Healthcare Common Procedures Coding System (HCPCS) ICD-9 ICD-10
  • Claims / Medical Management review
  • Collaborative relationships
  • Insurance industry experience

Timeline

Sales Manager

True Solutions
09.2018 - 11.2019

Claims Examiner III

Medix Staffing Solution - Prospect Medical Systems
11.2013 - 04.2018

Sales Representative/Debt Collector

Kentwood Law Group
07.2012 - 11.2013

Notary Commission / Signing Agent

Notary Learning Center

Life, Health And Accident Insurance Producer

EXCEL Solutions

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Amanda Loya