Jasmin Rivera
DeLand,Florida
Summary
Licensed insurance professional with strong background in claims management and risk assessment. Proven track record in efficiently handling complex cases, ensuring compliance, and delivering exceptional outcomes. Known for exceptional problem-solving skills, adaptability to changing needs, and fostering collaborative team environments. Highly reliable, with keen focus on negotiation, analysis, and customer service. Experienced healthcare professional with experience in patient care, critical thinking, and communication. I am a team player who consistently delivers results even in challenging situations. I am also dedicated, adaptable, loyal oriented, flexible, ambitious, team player, and highly motivated to not only succeed in any position but also grow. I take pride in my work, myself and derive considerable satisfaction from doing assignments well. I cope well with high stress situations and can manage a variety of projects. Strong advocate for a team works together on a common goal and depend on each other to get things done.
Overview
15
15
years of professional experience
Work History
Licensed Claims Adjuster
State Farm
07.2024 - Current
- Assisted in training new adjusters, sharing expertise and knowledge of industry standards and best practices.
- Answered customer questions regarding deductibles.
- Prepared summaries of damage, payments, and policy coverage.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Identified suspicious losses and contacted manager for investigative assistance.
- Developed strong relationships with service providers to facilitate prompt repairs or replacements for policyholders'' damaged property.
- Increased customer satisfaction by efficiently resolving claim disputes and providing timely updates on claim status.
- Demonstrated exceptional problem-solving abilities while handling challenging cases involving unique circumstances.
- Streamlined communication between departments by actively participating in interdepartmental meetings regarding ongoing claims issues or trends.
- Enhanced company reputation by demonstrating professionalism and empathy during interactions with policyholders in difficult situations.
- Collaborated with other adjusters to share best practices, ensuring consistent quality across the team.
- Provided guidance to policyholders throughout the claims process, ensuring they understood their coverage limits and obligations under their policies.
- Effectively managed time and resources to handle a high volume of claims without sacrificing quality or accuracy.
- Maintained compliance with state regulations through continuing education courses and adherence to established procedures.
- Improved workflow efficiency by implementing organizational systems for tracking claims progress and updating case notes regularly.
- Managed high caseloads, prioritizing claims for efficient processing and expedited payment approvals.
Ophthalmic Medical Technician
Central Florida Eye Specialists
11.2021 - 06.2024
- Assisted in developing an efficient system for inventory management of supplies used within the clinic, streamlining the ordering process and reducing waste.
- Examined the cornea, lens, and interior ocular chamber of eye using slit lamp. Take full medical history, eye drop administration for dilation, assessed intra ocular pressure, refract, confrontation fields, motility check, and pupil check.
- Enhanced diagnostic process for physicians with precise ocular measurements using advanced ophthalmic equipment.
- Implemented eye health education by providing patients with informative materials on proper eye wear use, hygiene practices, and disease prevention strategies.
- Scribed for the ophthalmologist / optometrist during examination; efficiently.
- Coordinate referrals to outside facilities for further testing.
- Responsible for patient work ups including taking medical history, eye
- Performed all test necessary for accurate diagnosis such as visual field (HVF), Pachymetry, Optical Coherence Testing, Corneal topography, fundus photos for retinal detachment, diabetic, macular degeneration, glaucoma, and glaucoma suspect.
- Provide proper drops to prep patients for Yag, SLT, and LPI surgeries.
- E-prescribed medications, completed paperwork for surgery, coded encounter forms, faxed reports, and tests, performed billing for visits using Electronic Medical Records with ICD 9/10 codes.
- Assisted physicians with procedures such as chalazion, lid lesion excisions; obtained consent forms if necessary.
- Triage patient calls and questions.
- Submitted electronic claim documentation for timely manner.
- Recognized emergent situations and initiated appropriate plan of action.
- Monitored ophthalmologist / optometrist schedules for efficiency
- Reduced patient wait times through efficient pre-examination procedures.
- Medical coding
Ophthalmic Medical Technician
Tomoka Eye Associates
07.2010 - 11.2021
- Examined the cornea, lens, and interior ocular chamber of eye using slit lamp. Taking full medical history, eye drop administration for dilation, assessed intra ocular pressure through Goldmann applanation, refract, confrontation fields, motility check, and pupil check.
- Gathered relevant information from patients to keep medication and medical diagnosis records accurate.
- Performed all test necessary for accurate diagnosis such as visual field (HVF), Pachymetry, Optical Coherence Testing, Corneal topography, fundus photos for retinal detachment, diabetic, macular degeneration, glaucoma, and glaucoma suspect.
- PRK pre-op exams including Wavefront scan.
- E-prescribed medications, completed paperwork for surgery, coded encounter forms, faxed reports, and tests, performed billing for visits using Electronic Medical Records with ICD 9/10 codes.
- Assisted physicians with procedures such as chalazion, lid lesion excisions; obtained consent forms if necessary.
- Triage patient calls and questions.
- Submitted electronic claim documentation for timely manner.
- Performed A-scan and Corneal topography for scheduled cataract extractions.
- Educated patients regarding proper eye health and hygiene. Demonstrated how to properly clean eyes, instill artificial tears and correctly do warm compress.
- Recognized emergent situations and initiated appropriate plan of action.
- Monitored ophthalmologist / optometrist schedules for efficiency.
- Scribed for the ophthalmologist / optometrist during examination; efficiently.
- Coordinate referrals to outside facilities for further testing.
- Aided in maintaining consistent patient flow in a busy clinical office.
- Explained treatment procedures, medications, diet, or physicians' instructions to patients.
- Prepared doctor's rooms, uncovering equipment and escorting patients out.
- Optimized clinical efficiency by calibrating ophthalmic instruments regularly to ensure accurate readings during exams.
- Streamlined office workflow by efficiently managing patient schedules, appointments, and medical records.
- Assisted in successful surgical procedures by providing attentive support to surgeons and maintaining a sterile environment.
- Participated in ongoing professional development opportunities to remain current on industry advancements related to ophthalmic technology and best practices in eye care services delivery.
- Supported practice growth by fostering strong patient relationships through empathetic listening skills and personalized recommendations for eye care services.
Education
General
Naugatuck High School
Naugatuck, CT06-1998
Skills
- Customer service
- Claims investigation
- Attention to detail
- Multitasking and organization
- Critical thinking
- Excellent problem solver
- Active listening
- Decision-making
- Quality-focused
- Self-motivated
- Great people skills
- Dedicated team player
- Verbal and written communication skills
- Licensed claims adjuster
- Medical coding
- Strong clinical judgment
- Compassion and empathy
Languages
Spanish
Native or Bilingual
Timeline
Licensed Claims Adjuster
State Farm
07.2024 - Current
Ophthalmic Medical Technician
Central Florida Eye Specialists
11.2021 - 06.2024
Ophthalmic Medical Technician
Tomoka Eye Associates
07.2010 - 11.2021
General
Naugatuck High School
Similar Profiles
ALBERTO ESCOBAR RUIZALBERTO ESCOBAR RUIZ
Claim Specialist; and Producer at State Farm Corporate & State Farm AgencyClaim Specialist; and Producer at State Farm Corporate & State Farm Agency
Bethany GandyBethany Gandy
Insurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State FarmInsurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State Farm
Ryan RogierRyan Rogier
Auto Estimatics Appraiser at State FarmAuto Estimatics Appraiser at State Farm
ISRRAEL RIVERAISRRAEL RIVERA
Field Claims Adjuster at State FarmField Claims Adjuster at State Farm
Zykia McNairZykia McNair
Assistant Basketball Coach at FBC Next UpAssistant Basketball Coach at FBC Next Up