Dawn Scott
Philadelphia,PA
Summary
Claims Specialist with over 11 years of experience in processing complex claims, ensuring compliance, and resolving discrepancies. Proven ability to collaborate with clients and effectively communicate updates, contributing to efficient claims management.
Overview
12
12
years of professional experience
Work History
Claims Specialist
SSA
Philadelphia , Pa
11.2013 - 05.2025
- Processed complex claims for disability and retirement benefits efficiently.
- Reviewed documentation to ensure compliance with federal regulations and guidelines.
- Collaborated with clients to gather necessary information for claim processing.
- Conducted thorough investigations to resolve discrepancies in claim submissions.
- Communicated updates and decisions to claimants and their approved representative or attorney of record. regarding claim status.
- Assisted in training new staff on claims processing procedures and systems.
- Utilized specialized software to track and manage claims throughout the lifecycle.
- Maintained detailed records of all claim activities including notes about conversations with claimants or representatives.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Provided customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Communicated with other departments within the organization to resolve issues related to claims processing.
- Processed payments for valid claims according to established procedures.
- Maintained up-to-date knowledge of regulatory changes affecting claims processing.
Education
High School Diploma -
West Catholic High School For Girls
Philadelphia, PA06-1985
Skills
- Claims processing
- Documentation review
- Discrepancy resolution
- Benefits verification
- Payment processing
- Effective communication
- Problem solving
- Time management
- Verbal communication
- Policy interpretation
- Claims analysis
- Claims
- Adaptability and flexibility
- Client interviews
- Time management abilities
- New policies processing
- Teamwork
Timeline
Claims Specialist
SSA
11.2013 - 05.2025
High School Diploma -
West Catholic High School For Girls