Jespa awomah
Yucca Valley,CA
Summary
Detail-oriented and results-driven Claims Specialist with over 5 years of experience in insurance claims processing, denial management, and resolution, currently serving as a Security Professional at Allied Universal. Skilled in analyzing policy coverage, investigating complex claims, negotiating settlements, and ensuring regulatory compliance, while delivering exceptional customer service. Known for excellent communication, adaptability, and collaboration across cross-functional teams to improve claim approval rates and operational efficiency. Proficient in Microsoft Office, document scanning, and time management, with a strong commitment to continuous learning—currently pursuing CompTIA Security+ and Network+ certifications. Highly dependable, organized, and tech-savvy, with a proactive mindset and a positive approach to problem-solving in fast-paced environments.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Claims Specialist | Claims Denials Analyst
St. John’s Community Health
01.2025 - Current
- Reviewed and processed insurance claims to ensure compliance with company policies and regulatory requirements.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Analyzed claim documents for accuracy, identifying discrepancies and implementing corrective measures when necessary.
- Developed training materials to enhance team understanding of claims processing systems and best practices.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- High-volume processing: Processed claims accurately and in compliance with payer rules and standards.
Security Officer
Allied Universal
06.2023 - 12.2024
- Monitored premises to ensure safety and security of staff and visitors.
- Conducted regular patrols to identify and address potential security risks.
- Responded promptly to incidents, ensuring proper procedures followed for resolution.
- Assisted in training new security personnel on protocols and emergency procedures.
- Maintained accurate records of daily activities, incidents, and observations for review.
- Provided exceptional customer service while enforcing facility rules and regulations.
- Patrolled and monitored premises in company vehicle, on bicycle, and by foot.
- Checked identification of persons entering and exiting facility to eliminate unauthorized visitors.
Medical Claims Processor
DRV Medical Inc
04.2022 - 06.2023
- Processed medical claims accurately and efficiently, ensuring compliance with industry regulations.
- Reviewed claim submissions for completeness, identifying discrepancies and facilitating timely resolutions.
- Coordinated with healthcare providers to clarify billing issues and enhance communication regarding claims status.
- Utilized electronic health record systems to input data, track claims progress, and maintain accurate records.
- Researched and resolved complex medical claims issues to support timely processing.
- Systems utilized: AMISYS (Advance) for plan administration and claims adjudication; Cenpas for payment and settlement workflows; Epic for clinical/billing context.
Amazon Delivery Dispatcher,
Amazon Delivery Sgl Logistic
04.2021 - 02.2022
- Coordinated daily delivery schedules to optimize route efficiency and minimize delays.
- Monitored vehicle locations using GPS tracking systems to ensure timely deliveries.
- Communicated with drivers to provide updates and resolve issues during delivery operations.
- Logged and documented delivery confirmations to maintain accurate records for management review.
FC Associate I
Amazon
04.2020 - 10.2020
- Operated warehouse equipment to efficiently manage inventory and fulfill orders.
- Assisted in maintaining accurate stock levels through regular cycle counts and audits.
- Collaborated with team members to optimize workflow and improve order processing times.
- Handled incoming shipments, ensuring proper documentation and organization of products.
- Maintained compliance with company safety policies and called violations to attention of management.
- Loaded and unloaded trucks efficiently using appropriate equipment such as pallet jacks or forklifts when necessary.
- Unloaded deliveries into warehouse and arranged contents in designated storage areas.
- Increased customer satisfaction by ensuring timely and precise order fulfillment, maintaining communication throughout the process.
Stocker,
99 Cent Only Store
03.2019 - 04.2020
- Organized merchandise on shelves to optimize product visibility and accessibility.
- Assisted in inventory management by restocking items and removing expired products.
- Maintained cleanliness and safety standards in storage areas and sales floors.
- Collaborated with team members to ensure efficient stock replenishment processes.
Education
No Degree - Computer And Information Systems
El Camino College
Torrance, CAGoogle IT Support Professional Certificate -
Google It Support
10-2024
High School Diploma -
El Segundo High School
El Segundo, CA06-2018
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
- Microsoft office
- Customer service
- Documentation skills
- Information verification
- Took 4 semester coursework of window server and Microsoft office excel, access,
Completed firsthand coursework covering
Microsoft 365, Excel, Windows 10, ServiceNow
Ticketing system, fundamental cloud concepts, and PC maintenance and performance
Certification
- Google IT Support Professional Certificate – 2024
Timeline
Claims Specialist | Claims Denials Analyst
St. John’s Community Health
01.2025 - Current
Security Officer
Allied Universal
06.2023 - 12.2024
Medical Claims Processor
DRV Medical Inc
04.2022 - 06.2023
Amazon Delivery Dispatcher,
Amazon Delivery Sgl Logistic
04.2021 - 02.2022
FC Associate I
Amazon
04.2020 - 10.2020
Stocker,
99 Cent Only Store
03.2019 - 04.2020
No Degree - Computer And Information Systems
El Camino College
Google IT Support Professional Certificate -
Google It Support
High School Diploma -
El Segundo High School
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