Summary
Overview
Work History
Skills
Certification
Timeline
Generic

Guadalupe Martinez

Nevada,TX

Summary

Accomplished Claim Adjuster with a proven track record at IA American Warranty, adept in claims investigation and negotiation, ensuring minimal financial risk. Excelled in customer service, significantly improving patient satisfaction at Community Medical Centers. Skilled in policy interpretation and team collaboration, consistently achieving favorable outcomes and maintaining compliance with regulatory standards.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Claim Adjuster

IA American Warranty
07.2022 - Current
  • Negotiated favorable settlements with claimants, and other insurance carriers to minimize financial risk for the company.
  • Examined claims forms and other records to determine insurance coverage.
  • Verified insurance claims and determined fair amount for settlement.
  • Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
  • Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.

Patient Service Representative

Community Medical Centers
04.2019 - 10.2020
  • Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
  • Verified insurance eligibility and coverage for patients.
  • Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
  • Filed and maintained patient records in accordance with HIPAA regulations.
  • Provided exceptional customer service to patients, answering questions and addressing concerns.
  • Managed patient registration process, confirming data accuracy and completeness.
  • Improved patient satisfaction by providing exceptional customer service during check-in and check-out processes.

Clerk

Secure Transportation
09.2012 - 02.2014
  • Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
  • Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
  • Improved customer satisfaction by promptly answering inquiries and providing accurate information.
  • Managed incoming calls professionally, directing callers to appropriate personnel or taking detailed messages when necessary.
  • Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment.
  • Maintained filing system and organized customer documents for easy retrieval of information.
  • Reduced errors in data entry through rigorous attention to detail and double-checking work.

Office Assistant

Stockton WorkNet Center
01.2010 - 05.2012
  • Maintained confidentiality in handling sensitive information while performing administrative tasks.
  • Enhanced office efficiency by managing schedules, organizing files, and maintaining a clean workspace.
  • Facilitated smooth operations by efficiently handling incoming mail, phone calls, and visitor inquiries.
  • Expedited document processing with accurate data entry and timely filing.
  • Increased customer satisfaction by providing professional and courteous front desk support.
  • Contributed to a positive work environment by fostering open communication among colleagues.
  • Supported executive staff with well-prepared reports, presentations, and meeting materials.
  • Improved data accuracy, entering and updating records in database with keen eye for detail.
  • Assisted in preparation of reports and presentations, which contributed to informed decision-making processes.

Skills

  • Claims Investigation
  • Highly motivated
  • Claims Processing
  • Advanced oral and written communication skills
  • Policy Interpretation
  • Computer Skills
  • Customer service and support
  • Team Collaboration
  • Claims adjustment

Certification

Administrative Medical Assistant

Timeline

Claim Adjuster

IA American Warranty
07.2022 - Current

Patient Service Representative

Community Medical Centers
04.2019 - 10.2020

Clerk

Secure Transportation
09.2012 - 02.2014

Office Assistant

Stockton WorkNet Center
01.2010 - 05.2012

Administrative Medical Assistant

Similar Profiles

CREATE PROFILE
Guadalupe Martinez