Chelsea Simmons

Claims Accident and Disability Specialist

Aflac

Columbus, GA

06.2014 - 02.2024

Reviewed medical records and other documents relating to an individual's injury or death due to an accident.
Processed insurance claims forms for reimbursement purposes.
Performed administrative duties such as filing insurance claims forms or preparing reports.
Adhered to state and federal regulations regarding insurance claims processing.
Reviewed insurance claims for accuracy prior to submission to ensure timely reimbursement from insurers.
Participated in training sessions for new employees regarding best practices for adjusting insurance claims.
Processed insurance claims electronically and followed up on any denied or pending claims.
Processed insurance claims related to services rendered by the office staff.
Processed insurance claims, appeals, and follow-up documentation.
Reviewed and processed insurance claims according to established procedures.
Managed daily paperwork related to billing operations, insurance claims processing, and filing of medical records.
Provided customer service to internal and external customers related to health insurance claims, billing issues, and policy questions.
Managed insurance claims processing and submission for reimbursement from health care providers.
Verified authenticity of documents submitted by customers to process life insurance claims.
Assisted in resolving customer inquiries and complaints regarding insurance claims processing.
Conducted research on laws and regulations related to insurance claims processing procedures.
Provided assistance with documentation required for insurance claims processing.
Processed insurance claims for reimbursement on a timely basis.
Researched relevant laws and regulations applicable to the investigation of insurance claims.
Documented all interactions related to health insurance claims processing in a secure system.
Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
Reviewed policies, procedures and regulations pertaining to the processing of insurance claims.
Assisted in training new staff members on procedures related to filing and processing insurance claims.