Lottie Marcelin
Summary
Dynamic insurance claims processor with proven expertise at Pearl Holding Group in claims management and regulatory compliance. Adept at fraud detection and data analysis, I excel in enhancing operational efficiency and client satisfaction through effective communication and meticulous attention to detail. Committed to delivering results in fast-paced environments.
Overview
18
18
years of professional experience
Work History
Insurance Claims Processor
Pearl Holding Group
Fort Lauderdale
02.2011 - 06.2025
- Verified documents and assessed eligibility to process insurance claims efficiently.
- Reviewed claim submissions for accuracy and completeness, ensuring compliance with standards.
- Communicated with clients to gather essential information for effective claims processing.
- Coordinated with adjusters to resolve discrepancies in evaluations of submitted claims.
- Utilized claims management software to monitor and update claim statuses effectively.
- Managed electronic filing systems to maintain organized records of all claims.
- Analyzed data from submitted claims to identify potential fraud cases.
- Participated in training sessions to stay updated on government regulations regarding health care benefits.
Support Services Specialist
City Of Lauderhill Police Department
Lauderhill
02.2008 - 02.2009
- Streamlined departmental correspondence to enhance operational efficiency.
- Maintained organized filing systems for quick document retrieval.
- Prepared reports and presentations utilizing office software proficiently.
- Directed incoming calls to appropriate personnel for effective communication.
- Managed office supplies inventory by monitoring stock levels and placing orders when necessary.
- Oversaw reception area, greeting visitors and managing package deliveries effectively.
Customer Service Agent
Consumer Health Benefits
Coconut Creek
02.2007 - 02.2008
- Resolved customer inquiries regarding health benefits and policy details.
- Efficiently handled customer complaints and escalated issues as needed.
- Processed benefit claims, ensuring accurate documentation for each request.
Skills
- Claims processing and management
- Regulatory compliance and insurance regulations
- Fraud detection and document verification
- Data analysis and claims analysis
- Customer service and client relationship management
- Effective communication skills
- Attention to detail
- Organizational skills
- Problem solving
Timeline
Insurance Claims Processor
Pearl Holding Group
02.2011 - 06.2025
Support Services Specialist
City Of Lauderhill Police Department
02.2008 - 02.2009
Customer Service Agent
Consumer Health Benefits
02.2007 - 02.2008
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