Jasmin Williams
Integra Partners
Alton,IL
5
years of professional experience
Results-driven Claims Specialist with extensive experience in claims processing, analysis, and investigation. Adept at evaluating, documenting, and resolving complex insurance claims while ensuring regulatory compliance. Recognized for enhancing claims accuracy, reducing processing times, and improving customer satisfaction. Expertise in risk assessment, fraud detection, and claims system optimization. Dedicated to streamlining workflows and delivering exceptional service in fast-paced environments.
Work History
Utilization Management Coordinator
7 Months- Reviewed and analyzed utilization data to identify trends and areas for improvement in patient care.
- Collaborated with interdisciplinary teams to implement best practices for efficient resource allocation.
- Facilitated communication between healthcare providers and patients to ensure optimal care coordination.
- Developed and maintained comprehensive documentation of utilization management processes and procedures.
- Utilized electronic health record (EHR) systems to enhance data tracking and reporting accuracy.
Claims Analyst
1 Year 4 Months- Processed claims across multiple insurance lines while maintaining compliance with industry regulations and company policies
- Conducted detailed claim audits to ensure accuracy and identified potential risks or fraudulent activity
- Collaborated with adjusters, legal teams, and external vendors to ensure efficient and fair resolution of claims
- Utilized claims management software to streamline claim handling workflows and minimize manual errors
- Developed reports on claims trends to drive process improvements and enhance operational efficiency
- Trained junior claims associates to improve team skill sets and ensure knowledge retention
- Supported policyholders and stakeholders by providing clear communication and guidance throughout the claims process
- Performed work remotely while maintaining productivity and communication
Senior Claims Processor
1 Year 7 Months- Managed a high-volume caseload while ensuring compliance with company guidelines and industry best practices
- Evaluated and adjudicated claims by analyzing policy coverage, legal standards, and claim details
- Supported policyholders by clarifying coverage details and facilitating claims resolution
- Investigated potential fraud cases and escalated findings for thorough review
- Partnered with underwriters to refine policy interpretations and improve claims decision-making processes
- Contributed to implementation of system enhancements, streamlining claims processing workflows
- Conducted internal audits to ensure compliance with claims policies and regulatory requirements
- Executed job responsibilities remotely from home office
Claims Adjuster
1 Year 3 Months- Conducted detailed investigations and inspections to assess damages, determine liability, and evaluate settlement options, ensuring fair outcomes for policyholders
- Performed detailed investigations and inspections to assess damages, determined liability, and evaluated settlement options
- Negotiated claim settlements with policyholders and third parties in accordance with industry regulations
- Documented claim evaluations to maintain transparency and adherence to compliance standards
- Coordinated with repair vendors and service providers to expedite claims resolution, enhancing customer satisfaction through timely support
- Trained new adjusters to enhance team expertise and operational effectiveness, contributing to improved claims handling processes
- Assisted in the training of new adjusters to strengthen team expertise and improve operational effectiveness
- Completed tasks remotely from home office
Education
High School Diploma
Name of High School Hazelwood Central High School
Medical Assistant
Skills
Utilization review
Fraud investigation
Insurance policy interpretation
Claims handling
Liability assessment
Compliance risk management
Claims denial management and appeals
Stakeholder engagement
Settlement negotiation
Healthcare claims management
Care coordination
Data analysis and reporting
Quality assurance
Proficiency in claims software
Electronic claims processing and automation
Investigative research and analysis
Time management and multitasking
Record management
Report writing and documentation accuracy
Resource allocation
Customer service and conflict resolution
Negotiation strategies
Patient care assessment
Clinical documentation
Communication and team collaboration
Utilization assessment
Customer retention and service enhancement
Data entry and record management
Policy compliance
Timeline
Utilization Management Coordinator
Integra Partners
01.2026 - CurrentRead More
Claims Analyst
Meridian Insurance
09.2024 - 01.2026Read More
Senior Claims Processor
Home Doctors medical Group
02.2023 - 09.2024Read More
Claims Adjuster
Plushcare
11.2021 - 02.2023Read More
Hazelwood Central High School
High School Diploma
Read More
St.Louis College of Health Careers
Medical Assistant
Read More