Dorell Tolbert
CLAIMS : MEDICAL, LOA, AUTO, DISABILITY
McKinney,TX
Summary
MEDICAL/ FMLA & INS CLAIMS PROCESSOR
Effective Claims Processor with remote experience, strong background and rapport building with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Poised and empathetic when interacting with callers and policy holders. Exemplary worker with investigative skills when processing claims. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
18
18
years of professional experience
Work History
Disability Specialist I
Sedgwick
McKinney, US
05.2023 - Current
- Timely processing of leave for employees under FMLA and PFL guidelines
- Ensure all pertinent documentation has been received for claims
- Manage claim notation, send documents, respond to emails, calls, and build new claims
- Execute timely processing of approval and denials
- Attention to detail, self-management, time management, database and claim management
- Contribute to the productivity of team's efficiency and turn-around retention
- Ensure best practices for FMLA, PFL and Carer’s claims.
LOA Coordinator - Claims
Sedgwick
McKinney, US
08.2022 - 05.2023
- Process leave time for employees requesting time off under FMLA guidelines
- Ensure all pertinent documents have been received for claims
- Update notation, follow-up calls, send documents, respond to emails, building new claims to ensure timely processing of approval and denials within requested time
- Advises on coverage, and benefit plan explains claim process, and collects the required information
- Attention to detail and self-manage, time management, and database management
- Contribute to the productivity of team's efficiency and turn-around retention
- Ensure best practices for STD, LTD, DS, ADA, FMLA for Military, Bonding, Care’s claim as adhered to while also being mindful of co-morbidities involved.
Medical Payment Associate - Claims
Diverse Lynx, LLC
McKinney, US
10.2021 - 04.2022
- Report to PIP Manager and set up files in the CAS system
- Set up files for Thirty-five MP/PIP Adjusters Update insured files by notation, follow-up calls, and sending documents Attention to detail and self-manage, time management
- Advises insured on coverage, and benefit plan explains claim process, and collects the required demographics
- Contributed to the productivity of the team's efficiency and turnaround retention.
Administrative Assistant II
Lancesoft Inc
McKinney, US
08.2021 - 08.2021
- Provided administrative support to the executive team, including scheduling meetings and managing calendars.
- Organized and maintained filing systems for physical and electronic documents, ensuring accuracy and confidentiality of records.
- Greeted visitors in a professional manner, responding to inquiries and directing them to appropriate personnel.
- Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
Underwriter's Administrative Assistant
Endevis Inc
McKinney, US
02.2020 - 06.2020
- Updated documents and worked on projects as needed meeting timelines. Researching
•Database management via data entry involves a logistical nature, monitoring, and updating statistical reports via data entry. - Maintained professional relationship with Real Estate agents assigned in my territory, keeping abreast of market values and policies applied.
- Ensured correspondence and best practice's were adhered to in a timely matter along with attention to details .
Client Services Coordinator
Premier Workspaces
McKinney, US
04.2018 - 10.2019
- Recognized as the acting manager in absence of the GM; functioned as an in-house notary
- Devised and implemented new best practice procedures
- Served as a source of information, logistics, and work orders
- Maintained social media content and advertisements
- Processed and distributed mail, heavy data entry, and created templates and ads using Microsoft applications Produced monthly billing and revenue reports, Proofed and processed checks for deposits
- Training new and temporary office workers
- Assist with onboarding and exit procedures
- Assigned office keys and building cards
- Scheduling appointments, tours, meetings, and consultations
- Planned and executed weekly client events
- Created and compiled client files, welcome packets and maintained files and contracts
- Improved productivity and help increase revenue through social media content ads created
- Played an active part in retentions of clients and attracting new clients as well.
Social Media Content Reviewer
Genpact
McKinney, US
09.2017 - 02.2018
- Reviewed and evaluated content for accuracy, quality, and appropriateness to ensure compliance with company standards.
- Analyzed content for potential copyright or trademark infringement issues.
- Documented findings of each review in a detailed report.
- Created guidelines and procedures related to the review process.
- Completed projects under a non-disclosure agreement for a high-profile social media client.
Executive - Administrative Assistant
SVTronics Inc
McKinney, US
04.2017 - 05.2017
- Reviewed and processed expense reports and invoices for accuracy and completeness.
- Organized and maintained executive calendars, scheduled meetings, conferences, travel arrangements, and appointments.
- Provided secretarial support to the executive staff including composing correspondence, memos, presentations, reports and other documents as requested.
- Developed filing systems to maintain confidential records of personnel information and business activities in accordance with company policies.
OFFICE ASST. III (non-perm Status)
State of Washington Dept of Health and Human Servi
Tacoma, WA
12.2016 - 01.2017
- Provided assessments and counseling services to individuals with disabilities.
- Assisted in the development of individualized plans for clients with disabilities.
- Facilitated the integration of disabled persons into mainstream society.
- Developed and implemented disability-related policies, procedures, and practices.
- Processing eligibility documents for benefits, and assistance. Indexing forms and verification documents to be processed.
- Verified income, residence, and citizenship. Scanning, uploaded, and routed documents to case manager.
- Demographics worked with were homeless and disabled clients, screening and helping access programs and aides as applicable
Data Entry
State of Washington Dept of Health and Human Services
McKinney, US
06.2016 - 01.2017
- Processing mail, eligibility documents for benefits, and assistance
- Indexing forms and verification documents to be processed, sorting supporting documentation needed to verify income, residence, and citizenship Scanning, uploading, and routing documents to case managers, uploading all documents and supporting forms into Database
- Demographics worked with were homeless and disabled clients, screening and helping access programs and aides as applicable.
Forms & Records Analyst III (non-perm status)
State of Washington Dept of Health and Human Services
McKinney, US
06.2016 - 01.2017
- Ensured timely delivery of records requests as it relates to CPS cases in relation to abuse and foster cases
- Researched, records retrieval, background investigation, and redacting information as it related to the requestor's specific need and relation to each records request
- Data Entry, redacting, researching, and fact-checking.
FORMS & RECORDS ANALYST III (non-perm Status)
State of Washington Dept of Health and Human Servi
Olympia, WA
06.2016 - 12.2016
- Ensured timely delivery of records requests as it relates to CPS cases in relation to abuse and foster cases.
- Researched, records retrieval, background investigation, and redacting information as it related to the requestor's specific need and relation to each records request.
- Data Entry, redacting, researching, and fact-checking.
- Monitored adherence to HIPPA and Privacy Law Act.
Administrative Assistant - Remote (Volunteer work)
Just for Me Furniture
McKinney, US
11.2014 - 11.2015
- Provided administrative support to the online retail team. answering calls and escalating calls to next tier as needed.
- Organized and maintained filing systems for electronic documents, ensuring accuracy and confidentiality of records.
- Handle incoming calls responding to inquiries and directing them to appropriate personnel.
- Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
Administrative Assistant III
El Centro College-DCCCD
McKinney, US
05.2015 - 10.2015
- Provided administrative support to the executive team, including scheduling meetings and managing calendars.
- Organized and maintained filing systems for physical and electronic documents, ensuring accuracy and confidentiality of records.
- Greeted visitors in a professional manner, responding to inquiries and directing them to appropriate personnel.
- Composed letters, memos, reports, emails, presentations and other written correspondence as required by management staff.
Department Assistant II
Brookhaven College-DCCCD
McKinney, US
05.2011 - 02.2015
- Assisted in the preparation of departmental budgets and tracked spending.
- Created detailed reports to help track and analyze departmental performance.
- Managed daily operations, including scheduling meetings and coordinating resources.
- Provided administrative support for staff members, such as creating presentations and organizing documents.
Circulation Assistant II
Brookhaven College-DCCCD
McKinney, US
01.2006 - 05.2011
- Coordinated interlibrary loan requests with other libraries for requested items not available at our own facility.
- Managed inventory control processes such as weeding out outdated materials or adding new titles to collections.
- Distributed promotional literature regarding upcoming events, classes or programs hosted by the library.
- Assisted in preparing displays promoting new books or authors featured at the library.
Supervisor Emergency Call Center
FEMA
McKinney, US
09.2005 - 11.2005
- Directed the activities of a 30-member team
- Coordinated schedules, timecards, QA testing, call monitoring, and new hire training
- Supervised updates of scripts and operational manuals
- Schedule appointments for training, QA retention, and inter-department briefing.
Education
Bachelor of Science Coursework in Psychology -
Walden University
09.2023
Associate-(other) Coursework in Psychology -
Brookhaven Community College
01.2013
Associate-(other) Certificate in Phlebotomy /Coursework in Psychology - Psychology
Delgado Community College
New Orleans, LA01.1989
Associate-(other) Coursework in Psychology -
Louisiana State University
01.1988
High School Diploma - High School Diploma received. -
Francis T. Nicholls High School / K.I.P.P. Renaissance High School
01.1983
Skills
- Case Management, Medical, Auto Insurance, Real Estate, Eligibility
- Medical Terminology
- Quality Assurance
- Training/ Proctoring/ Orientation/ Onboarding/Offboarding
- Task Oriented & Detail Oriented
- Logistics: Procurement/ Scheduling
- Privacy and Data Security, HIPPA, and Privacy Act Laws compliance experience
- Event Planning /Team Building
- Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook), Novell (GroupWise), SIR, TAM, Juris, Datatel, Track-It (work order) Application, E-Connect, webinar software, Avaya phone system, CAS, WUN phone system, 35 wpm typing, Slack, Zoom, Google Suite/Workspace, Social Media Content, Invoicing, Property Manager System, some AP and AR work ATS (iCMS), ADP, CAS, HIS, LIS
- Cisco, Avaya, WUN phone and integrated multi-lined and switchboard phone systems
Websites
Work Preference
Work Type
Full TimeContract WorkLocation Preference
RemoteImportant To Me
Work-life balanceCareer advancementHealthcare benefitsStock Options / Equity / Profit Sharing4-day work weekCompany CulturePaid time offPaid sick leave401k matchPersonal development programsTimeline
Disability Specialist I
Sedgwick
05.2023 - Current
LOA Coordinator - Claims
Sedgwick
08.2022 - 05.2023
Medical Payment Associate - Claims
Diverse Lynx, LLC
10.2021 - 04.2022
Administrative Assistant II
Lancesoft Inc
08.2021 - 08.2021
Underwriter's Administrative Assistant
Endevis Inc
02.2020 - 06.2020
Client Services Coordinator
Premier Workspaces
04.2018 - 10.2019
Social Media Content Reviewer
Genpact
09.2017 - 02.2018
Executive - Administrative Assistant
SVTronics Inc
04.2017 - 05.2017
OFFICE ASST. III (non-perm Status)
State of Washington Dept of Health and Human Servi
12.2016 - 01.2017
FORMS & RECORDS ANALYST III (non-perm Status)
State of Washington Dept of Health and Human Servi
06.2016 - 12.2016
Data Entry
State of Washington Dept of Health and Human Services
06.2016 - 01.2017
Forms & Records Analyst III (non-perm status)
State of Washington Dept of Health and Human Services
06.2016 - 01.2017
Administrative Assistant III
El Centro College-DCCCD
05.2015 - 10.2015
Administrative Assistant - Remote (Volunteer work)
Just for Me Furniture
11.2014 - 11.2015
Department Assistant II
Brookhaven College-DCCCD
05.2011 - 02.2015
Circulation Assistant II
Brookhaven College-DCCCD
01.2006 - 05.2011
Supervisor Emergency Call Center
FEMA
09.2005 - 11.2005
Bachelor of Science Coursework in Psychology -
Walden University
Associate-(other) Coursework in Psychology -
Brookhaven Community College
Associate-(other) Certificate in Phlebotomy /Coursework in Psychology - Psychology
Delgado Community College
Associate-(other) Coursework in Psychology -
Louisiana State University
High School Diploma - High School Diploma received. -
Francis T. Nicholls High School / K.I.P.P. Renaissance High School