Janice Ohmit

• Engaged in conversation with customers to understand needs, resolve issues and answer questions.
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
• Conferred with customers by telephone or email to provide information about claims and contract rates.
• Adjusted claims to resolve customers' service or billing complaints.
• Mentored junior team members and answer questions and trained where needed.
• Exceeded established service goals with turn around times, productivity and quality.
• Collaborated with team members to stay current on inventory levels and resolve item issues.

• Entered and maintained risk information in various information systems.
• Conducted accurate and thorough risk selection with proper classification of insureds.
• Solicited and evaluated group insurance applications to approve or decline risks based on company guidelines.
• Determined level of acceptable risk by reviewing applications for coverage.

. Examined documents to determine degree of risk from health, financial standing and value and condition of property.

• Decreased value of substandard risk policy and specified endorsements.
• Understood and followed oral and written directions.
• Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
• Prioritized and organized tasks to efficiently accomplish service goals.
• Planned and completed group projects, working smoothly with others.
• Demonstrated leadership by making improvements to work processes and helping to train others.

• Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
• Communicated with other departments to establish action plans and manage open claims to closure.
• Resolved claims by approving or denying documentation, calculating benefits due and determining compensation settlement.
• Documented specific claims by completing and recording forms, reports and logs.
• Planned and conducted investigations of claims to confirm coverage and compensability.
• Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
• Investigated and analyzed requirements to improve timeliness of reports to customers.
• Used skills to establish productive working relationships with co-workers, managment, providers and patients.
• Collaborated with fellow team members to manage large volume of claims.
• Processed claims for payment or forwarded to appropriate personnel for further investigation
• Assisted claimants, providers and clients with problems or questions regarding claims.
• Checked documentation for appropriate coding, catching errors and making revisions.
• Organized information by using spreadsheets, databases or word processing applications.