J. Desiree Rust
Richland,WA
Summary
Highly skilled Senior Claims Examiner with sound knowledge of claims management processes and regulatory compliance. Strengths include thorough investigation, accurate claim assessment, and negotiation skills which have led to successful resolutions in past roles. Well-versed in managing complex cases, handling multiple tasks concurrently, and contributing positively to team objectives.
Overview
15
15
years of professional experience
Work History
Senior Claims Examiner/Administrative Assistant
Penser North America
Richland, Washington
07.2011 - Current
- Reviewed and processed claims for compliance with company policies and accuracy standards.
- Identified discrepancies, enhancing compliance through thorough reviews of submitted documents.
- Analyzed claim data using industry-standard software to detect potential fraud indicators.
- Audited agreements and documentation to quantify and verify claims.
- Approved payment requests by adhering to established guidelines and criteria.
- Communicated status updates to stakeholders, ensuring transparency in claims processing.
- Coordinated with clients to gather necessary documentation for timely resolutions.
- Established relationships with external providers to facilitate efficient claim resolution.
Education
Washington St. Self-Insurance Claims Administrator
Washington State
Washington09-2017
Bachelor of Arts - Child Consumer And Family Studies
Washington State University
Pullman, WA01-1993
Skills
- Claims review
- Data analysis
- Fraud detection
- Documentation management
- Compliance assessment
- Stakeholder communication
- Claims processing
- Time management
- Claim resolution
- Loss adjustment
Timeline
Senior Claims Examiner/Administrative Assistant
Penser North America
07.2011 - Current
Washington St. Self-Insurance Claims Administrator
Washington State
Bachelor of Arts - Child Consumer And Family Studies
Washington State University