Detail-oriented professional with experience in auto claims processing, medical billing, and customer service. Expertise in managing complex claims, ensuring compliance, and delivering exceptional support. Strong analytical and problem-solving skills, with a focus on leveraging transferable skills in insurance adjusting.
Overview
8
8
years of professional experience
1
1
Certification
Work History
AR Resolver
XPO Logistics
Fort Worth, Texas
09.2024 - Current
Evaluating trends and identifying root causes, examine patterns and trends in invoicing errors to determine their underlying causes. This involves investigating recurring issues and understanding how they impact the overall claims process.
Partnering with internal teams, collaborate with internal departments, such as billing and customer service, to address and rectify identified errors. Work closely with these teams to implement corrective measures and prevent similar issues from arising in the future.
Correcting and preventing errors, develop and recommend solutions to correct invoicing errors, and prevent them from recurring. This may involve updating procedures, enhancing communication channels, or implementing new checks and balances.
Reporting and documentation Maintain accurate records of invoicing errors, corrective actions taken, and any changes to procedures. Prepare reports to communicate findings and improvements to management.
Medical Billing/Claims Processor
Accommodating Health Services
Fort Worth, TX
10.2020 - 09.2023
Collaborating with Internal teams, partner with healthcare providers, billing departments, and insurance team members to address and resolve discrepancies in medical claims. Work with these teams to clarify billing issues and ensure that all necessary documentation is correctly submitted.
Correcting and preventing errors, implementing corrective actions to rectify billing inaccuracies, and enhancing the accuracy of future claims. Develop and recommend improvements to billing practices and procedures to minimize errors and optimize claim processing.
Ensuring compliance adheres to healthcare billing regulations, insurance policies, and industry standards to ensure that all claims are processed in compliance with legal and organizational requirements.
Auto Claims Specialist/ Customer Service
Bridgecrest
Fort Worth, TX
10.2016 - 10.2020
Customer Interaction: Serve as the primary point of contact for policyholders, answering their inquiries, explaining claim procedures, and providing updates throughout the claims process.
Evaluate Claims. Thoroughly review auto insurance claims, including vehicle damage reports, repair estimates, and policy coverage details, to determine claim validity and appropriate compensation.
Investigate Claims. Conduct detailed investigations into accidents or incidents, including reviewing police reports, interviewing involved parties, and assessing damages to ensure a fair and accurate claims decision.
Resolve Conflicts Address and resolve conflicts or disputes between policyholders, repair shops, and insurance providers. Negotiate settlements and clarify policy terms to ensure a fair resolution for all parties.