REBECCA SUBIA
Georgetown,USA
Summary
Claims specialist with proven expertise in claims evaluation and negotiation at State Farm. Known for clear communication and strong customer relationships that improve service outcomes. Self-directed, organized, and experienced in workflow optimization and staff training to support operational excellence.
Overview
1
1
Certification
17
17
years of professional experience
Work History
CLAIM SPECIALIST
State Farm
Richardson, Texas
01.2023 - Current
- Investigating, evaluating, negotiating, and settling claims
- Applying knowledge of policies and insurance regulations when determining coverage, liability, & damages
- Contacting customers by telephone, written correspondence and/or various electronic media
- Effectively managing work through task driven queues while multi-tasking in a fast-paced call center environment
- Supporting our customers through personalized, caring, and simple interactions
- Reviewed policies to ensure claims align with coverage terms and conditions.
- Collaborated with other departments within the organization to resolve issues related to claims processing.
DISTRICT CENTRAL SCHEDULER
Results Physiotherapy
Round Rock, TX
04.2021 - 01.2023
- Promoted as first district central scheduler for Austin market.
- Performed data entry of patient demographics into the practice management system.
- Developed scheduling protocols to optimize clinic efficiency and service delivery.
- Managed company calendar to ensure timely appointment scheduling and commitment fulfillment.
- Organized workflow by verifying and processing patient demographic information accurately.
- Facilitated referral conversions through communication with patients, physicians, and sales teams.
- Anticipated patient needs while coordinating with partners such as workers' compensation claims adjustors.
- Maintained and updated documentation for incoming referrals and insurance authorizations.
- Trained new staff on best practices for scheduling and software utilization.
PATIENT SUPPORT LEAD
Results Physiotherapy
Georgetown/Cedar Park, TX
11.2016 - 04.2021
- Oversaw administrative operations and front-end staff at clinic, ensuring efficient workflows.
- Awarded "district best" in referral to evaluation conversion within first 30 days.
- Coordinated patient scheduling to maximize therapist availability and optimize resources.
- Managed ongoing training and performance management for support staff.
- Processed medical records requests and maintained accurate patient demographics.
- Conducted interviews for open positions, enhancing team capabilities.
- Analyzed customer feedback data to identify improvement opportunities.
- Led support team in resolving patient inquiries promptly.
EARLY OUT SELF PAY SUPERVISOR
Financial Corporation of America
Austin, TX
05.2016 - 11.2016
- Supervised early out self-pay team to enhance customer service efficiency and effectiveness.
- Conducted new hire training and ongoing education for existing staff.
- Monitored employee productivity, providing constructive feedback and coaching for performance improvement.
- Managed customer inquiries, resolving issues effectively and professionally.
- Collaborated with management to develop comprehensive training materials for staff development.
- Answered team questions while assisting with account maintenance and escalated calls.
- Enforced daily productivity reviews to ensure adherence to production requirements.
- Built and monitored campaigns, analyzing production reports for completion status.
EARLY OUT INSURANCE REPRESENTATIVE
Financial Corporation of America
Austin, TX
10.2015 - 05.2016
- Collaborated with shared services and on-site management to meet client and HCA expectations daily.
- Interacted with clients off-site to address workload requirements, including file reviews and correspondence handling.
- Tracked remittances and verified data accuracy for efficient operations.
- Conducted account research to resolve misapplied payments, missing payments, and credit balances.
- Communicated requests for itemized statements, explanation of benefits, adjustments, and letters to shared services.
- Acted as liaison for claim disputes, ensuring timely follow-up and resolution for assigned accounts.
PATIENT ACCESS TEAM LEADER
Parallon (St. Davids South Austin Medical Center)
Austin, TX
05.2015 - 10.2015
- Provided daily feedback on registration processes and staffing issues to patient access supervisor.
- Assisted staff in compliance with department policies and procedures as needed.
- Oversaw daily registration activities to meet departmental standards consistently.
- Facilitated resolution of patient concerns effectively and promptly.
- Educated registration staff on role changes alongside supervisor guidance.
- Acted as supervisor during absence, reporting all issues upon return.
- Registered incoming patients in emergency department, ensured pre-certification authorization, and prepared patient charts.
- Led team meetings to discuss workflow enhancements and streamlined communication with other departments.
PATIENT ACCESS SERVICES REPRESENTATIVE
SSM Health Care
Baraboo, TX
06.2009 - 03.2015
- Executed duties per established standards, policies, and procedures within department.
- Coordinated with healthcare providers to streamline patient access processes.
- Maintained electronic health records with attention to detail and accuracy.
- Registered patients accurately to facilitate timely medical attention and pre-registration for admissions.
- Maintained meticulous attention to detail while adapting to changes in a high-pressure environment.
- Chaired outpatient experience team in 2014, enhancing patient satisfaction initiatives.
- Served as member of patient experience team (Press Ganey) from 2012 to 2015, contributing to service improvements.
- Received Employee of the Month award in January 2011 for exceptional performance.
- Developed training materials for department meetings, including orientation for new employees.
- Collaborated with clinical staff to assess patient needs and provide appropriate services.
Education
Master’s Degree - Administrative Leadership/ Adult Education
University of Wisconsin- Milwaukee
Milwaukee, Wisconsin01.2015
Bachelor’s Degree - Communications
University of Wisconsin-Milwaukee
Milwaukee, Wisconsin01.2009
Associates Degree - Arts and Sciences
University of Wisconsin Baraboo/Sauk County
Baraboo, Wisconsin01.2006
Skills
- Multi-tasking ability
- Relationship building
- Leadership expertise
- Organizational skills
- Self-starter
- Motivation
- Claims evaluation
- Negotiation strategies
- Claims processing
- Customer relationship management
- Workflow optimization
- Data accuracy verification
- Effective communication
- Attention to detail
- Staff training
- Team leadership
- Claims investigation
- Verbal communication
- Problem-solving skills
- Professionalism
- Adaptability
- Data entry
- Customer service excellence
- Detail orientation
- Time management
Certification
Property and Casualty Insurance License
Timeline
CLAIM SPECIALIST
State Farm
01.2023 - Current
DISTRICT CENTRAL SCHEDULER
Results Physiotherapy
04.2021 - 01.2023
PATIENT SUPPORT LEAD
Results Physiotherapy
11.2016 - 04.2021
EARLY OUT SELF PAY SUPERVISOR
Financial Corporation of America
05.2016 - 11.2016
EARLY OUT INSURANCE REPRESENTATIVE
Financial Corporation of America
10.2015 - 05.2016
PATIENT ACCESS TEAM LEADER
Parallon (St. Davids South Austin Medical Center)
05.2015 - 10.2015
PATIENT ACCESS SERVICES REPRESENTATIVE
SSM Health Care
06.2009 - 03.2015
Master’s Degree - Administrative Leadership/ Adult Education
University of Wisconsin- Milwaukee
Bachelor’s Degree - Communications
University of Wisconsin-Milwaukee
Associates Degree - Arts and Sciences
University of Wisconsin Baraboo/Sauk County