Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Heather Howell

League City,TX

Summary

Claims Examiner with deep knowledge of the Health and Accident Insurance industry. Solid abilities in developing objectives and strategies to settle Major Medical, Limited Medical, Critical Illness, and Accident claims. Excellent skills compiling, coding, categorizing and auditing information to process claims.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Claims Examiner

American National Insurance Company
11.2014 - Current
  • Review and assess claims determining benefits based on contractual terms and departmental guidelines while complying with state regulations.
  • Investigate pre-existing conditions and analyze medical records from various providers to determine the nature, extent, and severity of illness and injury to make informed benefit decisions.
  • Investigate, assess, negotiate, and settle highly complex claims based on their nature, severity, and medical status.
  • Analyzed information gathered by investigation and report findings and recommendations.
  • Provide timely and precise resolution of policyholder inquiries, updating systems with relevant data.


Customer Service Representative

American National Insurance Company
03.2008 - 11.2014
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Responded to customer requests for products, services, and company information.
  • Tracked customer service cases and updated service software with customer information.
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Exhibited high energy and professionalism when dealing with clients and staff.
  • Investigated and resolved customer inquiries and complaints quickly.

Education

Associate of Science - Business Administration

Lone Star College System
Spring, TX
12.2024

Skills

  • Microsoft Office Suite
  • Fraud detection
  • Investigative skills
  • Critical thinking
  • Decision-making abilities
  • Medical terminology
  • Insurance knowledge
  • Policy interpretation
  • Liability Determination

Certification

ICA Associate, Life and Health Claims (ALHC) Certification 2017


Loma Level 1 Insurance Fundamentals 2009

Timeline

Claims Examiner

American National Insurance Company
11.2014 - Current

Customer Service Representative

American National Insurance Company
03.2008 - 11.2014

Associate of Science - Business Administration

Lone Star College System

Similar Profiles

CREATE PROFILE
Heather Howell