ASIA Zinsmeister
Carson,CA
Summary
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines.
Pragmatic Insurance Verification Specialist touting 16 years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.
Overview
20
20
years of professional experience
Work History
Claims Processing Specialist/Senior Insurance Associate
AAA Of Southern California
10.2022 - Current
- Reduced claim errors by conducting thorough investigations and obtaining all necessary documentation.
- Improved claim processing efficiency by implementing streamlined procedures and workflow adjustments.
- Identified potential fraudulent claims through careful analysis of trends, patterns, and inconsistencies.
- Maintained up-to-date knowledge of industry regulations, ensuring accurate and compliant claims processing.
- Leveraged advanced software tools to quickly identify discrepancies, leading to more accurate claims decisions.
- Streamlined the appeals process for denied claims, resulting in faster resolution times for clients.
- Handled complex cases with a keen attention to detail, ensuring proper evaluation and adjudication of each claim.
- Improved customer satisfaction by addressing and resolving complex insurance claims in a timely manner.
- Collaborated with underwriting team to ensure accurate risk assessment and pricing.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Case Manager/Administrative Legal Assistant/
Attorneys On Demand
02.2018 - 10.2021
- Created customer support strategy to increase customer retention
- Reviewed, edited and proofread litigation for proper grammar, spelling and punctuation
- Reviewed Deed of Trust, Title Commitment and prior bankruptcies documents
- Revised and finalized letters, briefs and memos
- Contacted clients to schedule appointments and discuss progress of cases
- Assisted up to 20 lawyers at time
- Handled electronic court filings and coordinated court activities
- Prepared various exhibits for attorneys for public meetings, zoning commission meetings and legal resolutions
- Contacted witnesses to testify under oath at court hearings
- Communicated pertinent information to clients via phone, email and mail
- Researched bankruptcy loan files to confirm federal guideline compliance
- Assisted attorneys with reviewing and organizing witness reports
- Researched statutes, decisions, legal articles and codes
- Created weekly, monthly and quarterly expense reports
- Reviewed case files and reported case progress to clients
- Conducted background investigations on defendant.
- Collaborated with attorneys to prepare for litigation proceedings, ensuring accurate documentation and adherence to legal guidelines.
- Improved client relationships through effective communication and prompt resolution of issues related to collections activities.
- Streamlined the collections process by developing clear policies and procedures for internal staff to follow.
Lead Dispatcher
Falcon Transport Co.
02.2015 - 01.2018
- Facilitated prompt roadside assistance for stranded motorists by maintaining accurate location information and dispatching appropriate resources.
- Reduced response times by streamlining the dispatch process through effective communication and coordination between emergency responders and motorists.
- Managed high call volumes, ensuring timely support to distressed callers during peak hours and emergency situations.
- Improved dispatcher performance by providing ongoing training on company policies, procedures, and best practices in emergency roadside services.
- Maintained a thorough knowledge of local geography, road conditions, and traffic patterns to ensure accurate routing of assistance vehicles.
- Handled escalated calls with empathy and professionalism, resolving complex issues while maintaining a positive rapport with customers.
- Assisted in the recruitment and onboarding process of new dispatchers, contributing to a cohesive team environment focused on excellent customer service.
- Preserved accurate records of dispatched orders, deliveries and receipts.
- Monitored flow of paperwork and directed information to appropriate departments.
- Tracked and monitored vehicle performance and maintenance.
Office Manager / Customer Service Manager/PC Agent
Allstate Insurance
01.2005 - 01.2015
- Delivered exceptional customer service to individuals contacting company's call center for support and assistance
- Responsible for more than 3,800 individual and corporate accounts
- Support sales reps in opening new accounts and upgrading existing service
- Quickly and effectively solve customer challenges
- Maintain quality control/satisfaction records, constantly seeking new ways to improve customer service
- Entered customer interaction details in sales system to track requests, document problems and record solutions offered
- Educated clients on account services and resolved client inquiries regarding statement information and account balances
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
Education
Music Education -
Wilberforce University
Dominguez Hills, CarsonHigh School Diploma -
Los Angeles County High For The Arts
Los Angeles, Ca06.2004
Skills
Claim Amount Calculations
- Client Interviews
- Teamwork and Collaboration
- Billing Software
- Adherence to high customer service standards
- Complaint resolution
- MS Office expert
- Exceptional interpersonal communication
- Telemarketing expertise
- Claims Processing Software
- Insurance Regulations Understanding
- Transactions reconciliation
- Small Claims Payouts
- Eligibility Determination
- Insurance Claim Forms Review
- New Policies Processing
- Legal knowledge
- Documentation expertise
- Debt recovery
- Assertiveness
Accomplishments
Increased customer retention. Proactive planning led to notable increase in morale in all departments. Created customer satisfaction survey, drastically reducing potential problems.
Timeline
Claims Processing Specialist/Senior Insurance Associate
AAA Of Southern California
10.2022 - Current
Case Manager/Administrative Legal Assistant/
Attorneys On Demand
02.2018 - 10.2021
Lead Dispatcher
Falcon Transport Co.
02.2015 - 01.2018
Office Manager / Customer Service Manager/PC Agent
Allstate Insurance
01.2005 - 01.2015
Music Education -
Wilberforce University
High School Diploma -
Los Angeles County High For The Arts
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