Ilinangie Dorville
Miami
Summary
Dynamic Claims Representative with expertise in insurance claims review and conflict resolution at Sedgwick. Proven ability to enhance customer satisfaction through effective communication and data analysis. Recognized for maintaining compliance with HIPAA regulations while efficiently processing claims and policies, ensuring a seamless experience for clients.
Overview
8
8
years of professional experience
Work History
Claims Representative
Sedgwick
09.2019 - 12.2023
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Processed and recorded new policies and claims.
Customer Service Representative
Target
02.2016 - 04.2018
- Responded to customer requests for products, services, and company information.
- Collected and returned unpurchased or returned items to correct shelf locations and arranged displays to promote sales.
- Recommended, selected and helped locate and obtain out-of-stock product based on customer requests.
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
Education
Associate of Science - Psychology
Miami Dade College
Miami Florida05-2018
Skills
- Conflict resolution
- File management
- Data analysis
- Insurance claims review
Accomplishments
- Documented and resolved workers compensation disputes which led to resolution for customers
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Supervised team of 20 staff members.
Languages
Spanish
Full Professional
Timeline
Claims Representative
Sedgwick
09.2019 - 12.2023
Customer Service Representative
Target
02.2016 - 04.2018
Associate of Science - Psychology
Miami Dade College
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