Amber Levi
Wahiawa,HI
Summary
Seasoned Pet Insurance Specialist with excellent planning and problem solving abilities. Offering 4 years of experience and a willingness to take on any challenge. Organized, driven and adaptable professional with successful history managing high caseloads in fast-paced environments.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Claims Specialist II
Healthy Paws Pet Insurance & Foundation
Wahiawa, HI
09.2021 - Current
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Developed processes and procedures for appealing denied claims that improved efficiency and effectiveness.
- Maintained up-to-date knowledge of applicable laws, regulations, policies and procedures related to appeals processing.
Claims Specialist
Healthy Paws Pet Insurance
09.2018 - 09.2021
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers
- Audited over 75 complex claims per day
- Escalated files with significant indemnity exposure to supervisor for further investigation
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims
- Reviewed new files to determine current status of injury claim and to develop plan of action
- Advised others on legal and regulatory compliance matters
- Resolved complex, severe exposure claims using high service oriented file handling
- Verified client information by analyzing existing evidence on file
- Developed and implemented preventive maintenance procedures
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Researched and analyzed policy contracts to verify proper payment of claims
- Reviewed and appealed over 20 complex claims per day
- Evaluated insurance policies and analyzed damages to determine coverage
- Trained other claims staff members on proper handling and evaluation of injury claims
- Answered customer questions regarding deductibles
- Substantiated legitimate claims and denied unjustified claims
- Verified client information by analyzing existing evidence on file.
Dispatcher Manager
24hr Lockouts
Honolulu, HI
11.2016 - 01.2019
- Relayed work orders and information between work crews, supervisors, and field personnel.
- Worked with routing specialists, route managers and service department to optimize routes.
- Employed and trained 6 new recruits according to established guidelines to improve efficiency and productivity.
- Scheduled or dispatched workers, equipment or service vehicles to locations using radios or telephones.
- Managed a team of 5 dispatchers, providing guidance and support as needed.
Education
Associate of Science - Occupational Studies
Washtenaw Community College
12.2015
Skills
- Insurance Coverage Verification
- Claims Auditing
- Analytical Skills
- Insurance Terminology
- Performance Feedback
- Claims Processing
- Policy Interpretation
- Claims Investigation
Certification
Licensed Adjustor in all states- 3 years
References
References available upon request.
Timeline
Claims Specialist II
Healthy Paws Pet Insurance & Foundation
09.2021 - Current
Claims Specialist
Healthy Paws Pet Insurance
09.2018 - 09.2021
Dispatcher Manager
24hr Lockouts
11.2016 - 01.2019
Associate of Science - Occupational Studies
Washtenaw Community College
Licensed Adjustor in all states- 3 years
Similar Profiles
Tara M. MeehanTara M. Meehan
Marketing Director at Healthy Paws Pet InsuranceMarketing Director at Healthy Paws Pet Insurance
Ashlie BellAshlie Bell
Account Manager at Healthy Paws Pet InsuranceAccount Manager at Healthy Paws Pet Insurance
Mandy HafnerMandy Hafner
Externship for Veterinary Technician at Healthy Paws Vet ClinicExternship for Veterinary Technician at Healthy Paws Vet Clinic