Dorthea R. Bona
West Hartford,CT
Summary
Disability Claims Adjuster with over 4 years of experience overseeing Short Term Disability, Accident and Critical Illness claims. Adept in pre-determination investigations, policy interpretation and regulatory compliance. Recognized for delivering compassionate support to claimants while ensuring accurate, timely resolution of complex cases.
Overview
3
3
years of professional experience
Work History
Disability Claims Adjuster- Team Lead
The Loomis Company
Wyomissing, PA
12.2024 - 05.2025
- Managed annual caseload of 250 Short-Term Disability, Critical Illness, and Accident claims with precise calculations.
- Facilitated meetings with account managers, directors, clients, and adjusters to resolve complex claims.
- Developed streamlined procedures to enhance processing efficiency across multiple disability products.
- Conducted training sessions on claim protocols for adjusters and management, ensuring effective practices.
- Created comprehensive procedure guides and training materials to optimize operations.
- Oversaw training initiatives for disability department personnel.
- Established partnerships internally and externally to improve claims resolution processes.
Disability Claims Adjuster
The Loomis Company
Wyomissing, PA
03.2022 - 12.2024
- Ensured accurate processing of disability claims, complying with group policies and regulations.
- Communicated with policyholders and medical providers to gather essential information for claims.
- Maintained accurate records of claims activities, including payments, denials, and appeals.
- Reviewed medical records and police reports related to claim investigations.
- Developed processes to effectively track disability claims.
- Executed special projects efficiently, consistently meeting management deadlines.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
Medical Claims Adjuster
The Loomis Company
Wyomissing, PA
11.2021 - 03.2022
- Processed medical, accident and hospital indemnity claims using electronic systems and databases efficiently.
- Ensured accurate and compliant processing of claims in alignment with established policies, regulatory requirements, and departmental standards.
- Verified accuracy of provider data entered into the system including tax ID numbers, NPI numbers, address changes .
Skills
- AS400 and Illumifin claims systems
- Caseload management
- Regulatory compliance
- Claims investigation
- Policy interpretation
- Workflow optimization
- Conflict resolution
Affiliations
- Home renovations & furniture restorations
- Travel
- Motorcycle Enthusiast
References
References available upon request.
Timeline
Disability Claims Adjuster- Team Lead
The Loomis Company
12.2024 - 05.2025
Disability Claims Adjuster
The Loomis Company
03.2022 - 12.2024
Medical Claims Adjuster
The Loomis Company
11.2021 - 03.2022
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