Jessica Simes
New Richmond,WI
Summary
Proven track record in claims processing and customer service excellence, demonstrated at Dey Distributing. Skilled in data entry proficiency and active listening, efficiently managed high-volume claims with accuracy, ensuring compliance and enhancing customer satisfaction. Achieved significant improvements in processing efficiency and quality, contributing to team success through effective collaboration and training. Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
12
12
years of professional experience
Work History
Claims Processor
Dey Distributing
07.2019 - Current
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
- Followed up with customers on unresolved issues.
- Handled escalated customer concerns regarding claim denials or delays with empathy and professionalism.
- Calculated adjustments, and refunds.
- Processed and recorded new policies and claims.
- Posted payments to accounts and maintained records.
Paraprofessional
622 School District
09.2016 - 06.2019
- Oversaw students in classroom and common areas to monitor, enforce rules, and support lead teacher.
- Improved classroom management by assisting teachers with behavioral interventions and monitoring student progress.
- Supervised students during non-instructional periods such as lunch, recess, or field trips, ensuring safety at all times.
- Enhanced student support by delivering one-on-one and small group assistance in various subjects.
- Fostered positive learning environment by establishing strong rapport with students, parents, and faculty members.
- Supported special education teachers in implementing accommodations and modifications for students with diverse learning needs.
- Took part in professional development workshops to boost skills.
- Developed and implemented strategies to improve student engagement.
- Organized and led practice, research and lab assignments.
- Helped teacher prepare instructional material and displays.
- Supervised students on field trips for safety and proper behavior in public settings.
- Assisted in maintaining engaging and respectful educational environment by promoting discipline and cooperation.
- Enhanced classroom efficiency through organizing instructional materials, managing daily schedules, and preparing resources for lessons as needed.
- Implemented behavior management techniques effectively to maintain structured learning environment conducive to student success.
- Prepared instruction materials, constructed bulletin boards, and set up work areas.
- Relieved classroom teacher during breaks and maintained order and structure in classroom.
- Collaborated with teachers to develop and implement individualized education plans for students with special needs.
Home Daycare Provider
Self Employed Services
04.2012 - 08.2017
- Met with parents about daily activities, positive developments, and issues.
- Offered children numerous opportunities throughout each week to get sunshine and exercise in yard and at local parks.
- Sanitized dishes, tabletops, toys, and frequently touched surfaces to prevent spreading of germs.
- Streamlined administrative tasks such as enrollment paperwork processing resulting in efficiency improvements.
- Treated basic first aid needs such as cleaning and bandaging minor cuts.
- Taught children to organize toys, wash hands, and share by leading by example.
- Implemented conflict resolution techniques promoting peaceable resolutions among peers during disagreements.
- Balanced children's days between play, instruction, and rest with well-designed schedules.
- Administered nutritious meals and snacks to promote healthy eating habits in children.
- Organized engaging arts and crafts projects to foster creativity and fine motor skills among the children.
- Complied with state regulations regarding licensing, health requirements, staffing ratios, and safety protocols in the operation of the daycare facility.
- Promoted good social skills by helping children work through conflicts and leading many collaborative games.
- Delivered effective potty training strategies tailored to each child''s readiness level leading to successful outcomes.
- Crafted nutritious meals and kept lots of fresh fruit and vegetables on hand to prevent unhealthy snacking.
- Developed strong relationships with parents through open communication, addressing concerns, and providing updates on their child''s progress.
- Built early learning skills such as color and shape recognition with hands-on activities.
- Changed diapers of very young children and assisted older kids with bathroom requirements.
- Managed home environment to keep areas clean, organized and free of safety hazards.
- Applied positive behavior management techniques to enhance social interactions and emotional development.
Education
No Degree - Criminal Justice
Rasmussen College
Lake Elmo, MN06.2009
High School Diploma -
North High School
North St. Paul, MN06.2000
Skills
- Data Entry
- Attention to Detail
- Claims Processing
- Microsoft Office
- Excellent administrative abilities
- Customer Service
Timeline
Claims Processor
Dey Distributing
07.2019 - Current
Paraprofessional
622 School District
09.2016 - 06.2019
Home Daycare Provider
Self Employed Services
04.2012 - 08.2017
No Degree - Criminal Justice
Rasmussen College
High School Diploma -
North High School
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