Blythe Dixon
Houston,Texas
Summary
Highly motivated examination professional with experience in the insurance industry. Proven track record of efficiently processing a high volume of claims while ensuring accuracy and compliance. Excellent problem-solving and communication skills with a commitment to providing superior customer service. Experienced in working with complex medical and legal documents, and utilizing multiple computer systems to maintain accurate records.
Overview
8
8
years of professional experience
Work History
Disability Claims Examiner II
Prudential Life Insurance
10.2022 - Current
- Process and examine Long Term Disability Claims
- Make determinations and decisions on claims
- Provided efficient and courteous service to customers at all times.
- Skilled in using various software applications and programs including, Office and Adobe Creative Suite
- Demonstrated ability to manage multiple tasks while remaining adaptable and flexible
- Responded quickly to meet customer needs and resolve problems.
- Examined claims investigated by insurance adjusters, further investigating questionable claims to determine whether authorized payments
- Contacted or interviewed claimants, doctors, medical specialists, or employers to get additional information
- Participated in discussion at claim committee meetings.
Claims Examiner II
Amazon
04.2022 - 10.2022
- Remote
- DLS, Disability Leave Services
- Amazon, Remote, Responded quickly to meet customer needs and resolve problems.
- Demonstrated ability to manage multiple tasks while remaining adaptable and flexible
- Sought continuing education opportunities to stay current with industry trends
- Processed Short Term Disability claims and Leave Claims
Senior Ability Analyst
The Hartford
06.2021 - 03.2022
- Examined short term disability and leave claims
- Assisted customers over the phone and by email with their claims
- Handled the claims from start to finish
- Conducted virtual investigations with the claimant and made sure they understood the process
- Made decisions and determinations on claim outcomes
- Reviewed all documentation and calculated benefits as well
- A strong attention to detail and accuracy with a 100% quality score, as well as excellent customer service skills.
Medical Claims Adjuster
United Healthcare
07.2016 - 06.2017
- Contacted or interviewed claimants, doctors, medical specialists, or employers to get additional information
- Payed and processed claims within designated authority level.
- Entered claim payments, reserves, and new claims on computer system, inputted concise yet sufficient file documentation
- Investigated, evaluated and settled claims, applying technical knowledge, and human relations skills to achieve fair and prompt disposal of cases and to contribute to reduced loss ratio.
Education
Bachelor of Science - Biology
University of South Carolina - Columbia
Columbia, SCBachelor of Science - Psychology
University of Houston - Downtown
Houston, TX05.2024
Skills
- Medical Records Management
- Customer Service - 10 years
- Analytical and Critical Thinking - 10 years
- Corporate Policies and Procedures
- Customer Relations
- Case Notes
- Disability Claims Process
- Microsoft Office
- Claims Investigations
- Work Organizing and Prioritizing
- Long Term Disability Claims
- Short Term Disability Claims
- Workers Compensation Claims
- Billing Procedures
- Customer Inquiries
- Customer Satisfaction
- Account Management Expertise
- Client Service
- Group Benefits 5 years
Timeline
Disability Claims Examiner II
Prudential Life Insurance
10.2022 - Current
Claims Examiner II
Amazon
04.2022 - 10.2022
Senior Ability Analyst
The Hartford
06.2021 - 03.2022
Medical Claims Adjuster
United Healthcare
07.2016 - 06.2017
Bachelor of Science - Biology
University of South Carolina - Columbia
Bachelor of Science - Psychology
University of Houston - Downtown
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