JENNIFER BONELA
411 Merlin Court, Brandon ,Florida
Summary
Ambitious and performance driven Claims Generalist Associate who is looking to transition into a higher ranking position. Ability to work independently as well as on a team in a high pressure environment. Goal oriented and always aiming for the most precise outcome in all situations. Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in insurance policies, practices and standards.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Claims Generalist Associate
Progressive
09.2023 - Current
- Enhanced claim processing efficiency by thoroughly reviewing and analyzing documents submitted for each case.
- Expedited claim resolutions through effective communication with clients, providers, and other stakeholders.
- Reduced time spent on repetitive tasks by developing and implementing streamlined claims management procedures.
- Improved customer satisfaction ratings by providing prompt and accurate responses to inquiries regarding claim status.
- Minimized financial risks for the company by conducting in-depth investigations of potentially fraudulent claims.
- Collaborated with cross-functional teams to develop strategies for process improvements in claims handling operations.
- Managed high-volume caseloads while consistently meeting deadlines and maintaining quality standards for claim submissions.
- Provided expert guidance on policy interpretation, enabling coworkers to make informed decisions when evaluating coverage eligibility during the claims process.
- Maintained strong working knowledge of industry best practices, adapting internal processes accordingly to stay ahead of competitors.
- Provided top-notch customer service throughout the claims process, ensuring a positive experience for policyholders and reinforcing brand reputation.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
- Enhanced customer satisfaction by effectively managing liability claims and providing timely resolutions.
- Reduced claim processing time through efficient investigation and documentation of claim details.
Medical Claims Adjuster
Progressive
10.2017 - Current
- Managed large volume of medical claims on daily basis.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Responded to correspondence from insurance companies.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Reported policy changes and company conditions affecting customer satisfaction.
- Examined claims forms and other records to determine insurance coverage.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Assistant Case Manager / Administrative Assistant
THEODORE S. BILSKI AND ASSOCIATES
01.2006 - 10.2017
- Coordinated medical treatment for worker's compensation claims
- Co-Managed high volume of Worker's Compensation Claims.
- Maintained communications between adjusters, attorneys, and medical providers.
- Managed daily office operations and maintenance of equipment.
- Managed the day-to-day calendar for the company's senior director.
- Created weekly and monthly reports and presentations.
- Organized files, developed spreadsheets, faxed reports and scanned documents.
- Wrote reports and correspondence from dictation and handwritten notes.
- Designed electronic file systems and maintained electronic and paper files.
- Created and maintained spreadsheets using advanced Excel functions and calculations to develop reports and lists.
Patient Service Specialist
SELECT PHYSICAL THERAPY
01.2010 - 04.2014
Office Clerk
ADVANCED DIAGNOSTIC GROUP
01.2009 - 01.2011
- Scanned and filed forms, reports, correspondence and receipts.
- Retrieved requested files and delivered to appropriate personnel.
- Operated office equipment such as copiers and fax machines.
- Entered information into computer databases.
- Processed and routed incoming mail.
- Destroyed files and materials upon request.
- Reviewed files to check for complete and accurate information.
- Contacted staff and customers to retrieve files.
- Ordered and distributed office supplies while adhering to a fixed office budget.
- Helped distribute employee notices and mail around the office.
Education
Bachelor of Arts - CRIMINOLOGY
University of South Florida
Tampa2015
Associate of Arts - LIBERAL ARTS
Hillsborough Community College
Tampa, FL2010
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Hillsborough Community College
Brandon, FloridaSkills
- Medical Claims
- Workman's Compensation Case Management experience
- Microsoft Office proficiency
- Data Entry
- Excel spreadsheets
- Employee Training and Development
- Articulate and well-spoken
- Proper phone etiquette
- Ability to Multitask
- Excellent organizational skills
- Team player and self-motivated
- Claims Investigation
- Policy Knowledge
- Claims Processing
- Team Collaboration
- Time Management
Certification
Certified Personal Trainer - International Sports Sciences Association (ISSA)
Received: July 11, 2017
CPR/AED/First Aid
Received: 01/2017
Timeline
Claims Generalist Associate
Progressive
09.2023 - Current
Medical Claims Adjuster
Progressive
10.2017 - Current
Patient Service Specialist
SELECT PHYSICAL THERAPY
01.2010 - 04.2014
Office Clerk
ADVANCED DIAGNOSTIC GROUP
01.2009 - 01.2011
Assistant Case Manager / Administrative Assistant
THEODORE S. BILSKI AND ASSOCIATES
01.2006 - 10.2017
Bachelor of Arts - CRIMINOLOGY
University of South Florida
Associate of Arts - LIBERAL ARTS
Hillsborough Community College
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Hillsborough Community College