Elpidio Matos
Stockton,California
Summary
Experience administrative professional with excellent customer service, time management and multitasking abilities. Knowledgeable about handling insurance claims, drafting correspondence and coordinating files. Looking for a challenging role with a growing team. Claims Assistant with strong history of opening and closing file, processing documents and updating logs. Prioritizes tasks and uses sound judgment to make decisions on claim processing actions. Well-organized and hardworking with good written and verbal communication skills. Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach.
Overview
32
32
years of professional experience
1
1
Certification
Work History
Security Officer
Securitas Security Services USA
11.2021 - Current
- Greeted guests professionally and courteously to cultivate welcoming atmosphere while making safety top priority.
- Conducted regular patrols of key areas to spot and control security concerns.
- Acted quickly during emergency situations to reduce opportunity for damage and injury.
- Patrolled and monitored premises in company vehicle, on bicycle, and by foot.
Sr. Claims Assistant
Chubb Insurance / ACE American Insurance
12.2003 - 12.2021
- Transmitted case files between offices
- Logged, allocated and managed claims
- Prepared files, letters and notices
- Scheduled medical appointments
- Worked productively in fast-moving work environment to process large volumes of claims
- Carried out administrative tasks by communicating with clients, distributing mail and scanning documents
- Generated, posted and attached information to claim files
- Posted payments to accounts and maintained records
- Modified, updated and processed existing policies
- Reviewed outstanding requests and redirected workloads to complete projects on time
- Acted as financial subject matter expert, answering internal and external questions and inquiries
- Work collaboratively with Examiners, Supervisors, and Nurse Case Managers in the assigning of new and transferred claims based on segmentation guidelines and dedicated accounts
- Serve as Subject Matter Expert for reporting Workers Compensation Benefits EOR multiple states based on jurisdictional requirements
- Partner and serve as Subject Matter Expert with the automation team to modernize and improve the end-to-end claims process
- Participate on the Quality Audit team, identify trends and suggest improvements for more efficiency
- Prepare claim files for referrals to outside parties such as claimants, medical doctors, and attorneys
- Schedule medical examinations; send physician cover letters and medical reports with approval from the examiner
- Lead Quality Audits team to identify trends and suggested improvement(s) to increase efficiency.
Stocker / Forklift Operator
Walmart / Sam’s Club
06.1997 - 03.2003
- Operated Forklift, hand truck, and pallet jacks to load, unload and move product
- Collaborated with department stakeholders and floor managers to determine product placement
- Maintained Fleet by changing forklift batteries and ensuring daily inspections for safe operations
- Rotated stock to prevent out-of-date products and removed aging items
- Built Promotional displays
- Changed sales floor signs to show current pricing & support product promotions.
Crew Leader / Freezer Lead
Noah’s Bagels
08.1992 - 11.1997
- Team leader
- Conducted interviews, hiring and ensured team has essential training and equipment
- Conducted daily inventory control and ensured accuracy of all shipments
- Worked all positions and job tasks
- Researched any issues related to delivery of product and implemented resolution
- Ensured OSHA regulation compliance and maintained a safe work environment.
Education
GED -
San Francisco City College
San Francisco, CASkills
- Time Management
- File Management
- Check Distribution
- Customer Interaction
- Team Collaboration
- Monthly Reports
- Data Entry
Certification
- Claims Processing Professional
- Administrative and Software Application
- Certified Forklift Driver
Timeline
Security Officer
Securitas Security Services USA
11.2021 - Current
Sr. Claims Assistant
Chubb Insurance / ACE American Insurance
12.2003 - 12.2021
Stocker / Forklift Operator
Walmart / Sam’s Club
06.1997 - 03.2003
Crew Leader / Freezer Lead
Noah’s Bagels
08.1992 - 11.1997
GED -
San Francisco City College
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