Celia Amorette Braun

Analyze and manage new auto medical claims and complex cases, conducting comprehensive initial file reviews to identify fraud indicators, SUI referrals, coverage issues, legal disqualifications, policy exclusions, and liability concerns, enhancing the integrity of claim life cycle.

• Detail-oriented Medical Claims Specialist with extensive experience reviewing, resolving, and auditing complex medical claims involving bodily injury.
• Ensured claims compliance with policy terms, state insurance regulations, and jurisdictional requirements while managing high policy limit exposures.
• Provided escalation support for claims associates and call center intake teams on complex medical, billing, and customer-facing issues, which facilitated resolution.
• Identified payment discrepancies, overpayments, and billing irregularities, initiating recovery actions and provider outreach to rectify issues and maintain financial accuracy.
• Maintained detailed documentation to support audit readiness and regulatory reviews, contributing to internal quality assurance standards.

Senior Enlisted Leader in medical Operations and Administrative Medical Support for the 301st Fighter Wing.

• Coordinated scheduling, tasking, and administrative flow for multi‑disciplinary teams, ensuring seamless collaboration among technicians, adjusters, and customers.
• Conduct thorough analysis of medical data input into AFRC program databases, ensuring accuracy and compliance with regulatory standards.
• Mediated medical disputes and clarified expectations while maintaining professionalism under pressure, effectively addressing concerns and facilitating resolution.
• Oversee updates for dental class 1 & 2 within electronic health record systems, facilitating timely information flow for deploying members.
• Delivered clear, empathetic explanations of complex medical processes to patients and leadership, directly transferable to explaining AFRC timelines, critical findings, and cost breakdowns to service members.
• Serve as a member of the Medical Morale Association, fostering camaraderie and teamwork, which enhances unit engagement and overall member satisfaction.
• Developed and implemented strategies for continuous improvement in claims management processes, leveraging data-driven insights to identify trends and propose actionable solutions.

Passionate and highly knowledgeable automotive professional with hands‑on experience in vehicle maintenance, parts operations, sales, and damage assessment, continuous learning supported by a lifelong desire to work in the auto industry.

• Advised customers on OEM and aftermarket parts, tested parts, verified compatibility, and processed replacement orders with high accuracy to enhance customer satisfaction.
• Maintained stock levels, conducted cycle counts, managed vendor orders, and optimized parts storage for efficiency and accuracy.
• Coordinated routine maintenance and communicated repair needs to ensure timely service completion and uphold strong CSI scores.
• Prepared accurate mechanical and suspension repair estimates using OEM guidelines and shop labor standards.
• Performed initial damage inspections, documented findings, and collaborated with body technicians to determine repair paths.
• Processed service contracts, validated warranty coverage, submitted claims, and ensured compliance with manufacturer policies.
• Built relationships with body shops, independent repair facilities, and suppliers to negotiate pricing, secure hard-to-find parts, and streamline order fulfillment for improved service delivery.