Summary
Overview
Work History
Education
Skills
Timeline
Generic

ERIKA CROMOTY QUINN

Tampa,FL

Summary

Experienced Senior Claims Representative handles advanced insurance claims with minimal supervision. Knowledgeable about conducting investigations, managing workers comp, medical, dental, auto claims and approximating payouts.

Overview

22
22
years of professional experience

Work History

Medical Claims Processor

Anthem
Tampa, FL
09.2021 - Current
  • Process medical claims
  • Ensured compliance with applicable federal and state laws governing healthcare payments.
  • Resolved issues related to denied or underpaid claims in a timely manner.
  • Identified incorrect charges on invoices by comparing them against contracts and fee schedules.
  • Verified patient eligibility for medical claims and determined benefit coverage.

Data Entry Clerk Dental

LIBERTY Dental Plan
Tampa, FL
01.2021 - Current
  • Accurately handled data entry for [320] clients into company-based software for dental patients.
  • Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
  • Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
  • Used contract notes and processing manual to correctly apply group-specific classifications to claims.
  • Administered standard contract benefits to process pending claims for dental benefits.

Claims

PMSI
TAMPA, FL
10.2011 - 06.2012
  • Reviewed and submitted workers' compensation claims.
  • Coordinated workers' compensation insurance and managed claims.
  • Administered workers' compensation program covering injured employees.
  • Promoted safety processes to reduce workers' compensation and costs.

CLAIMS

Coventry Health Care
TAMPA, FL
12.2006 - 11.2009
  • Informed patients of claims status after filing insurance claims.
  • Communicated with insurance representatives to complete claims processing or resolve problem claims.
  • Rejected or approved claims.
  • Opened, sorted and monitored claims.

CSR AUTO

LIBERTY MUTUAL INSURANCE COMPANY
TAMPA, FL
01.2002 - 11.2006
  • Applied expertise in interpreting complex automobile policies to assess damages accurately.
  • Evaluated existing auto policy coverage levels to recommend changes that would better meet customer needs.
  • Reviewed and processed auto claims documents to ensure accuracy of information.
  • Conducted investigations, gathered evidence, and interviewed witnesses to determine liability in auto accident cases.
  • Negotiated settlements with claimants or their representatives to resolve disputes quickly and efficiently.

Education

Certification In All Lines Adjuster -

Central Insurance School
12.2022

High School Diploma -

King High School
01.1990

MICRO WORD PROCESSING -

FLORIDA COLLEGE OF BUSINESS
Tampa

Skills

  • 10-Key Certification
  • Multitasking and Prioritization
  • Data Entry
  • Error Identification
  • Data Processing
  • Document Scanning
  • Insurance Processing
  • Keyboard Entry
  • Medical Terminology
  • Spreadsheet Management
  • CMS-1500 Billing Forms
  • Insurance Eligibility
  • Medical Billing
  • Dental Terminology Knowledge
  • Microsoft Office
  • Claims Appeal Procedures
  • Trained in 10-Key
  • Correct Errors
  • Verify Data
  • Email Communication
  • Claims Resolution
  • Claims Investigation
  • Insurance Knowledge
  • Claims Management
  • Insurance Claims Processing

Timeline

Medical Claims Processor

Anthem
09.2021 - Current

Data Entry Clerk Dental

LIBERTY Dental Plan
01.2021 - Current

Claims

PMSI
10.2011 - 06.2012

CLAIMS

Coventry Health Care
12.2006 - 11.2009

CSR AUTO

LIBERTY MUTUAL INSURANCE COMPANY
01.2002 - 11.2006

Certification In All Lines Adjuster -

Central Insurance School

High School Diploma -

King High School

MICRO WORD PROCESSING -

FLORIDA COLLEGE OF BUSINESS

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ERIKA CROMOTY QUINN