Summary
Overview
Work History
Education
Skills
Timeline
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Jillian Kenney

Boonville,MO

Summary

Enthusiastic Claims Examiner eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Motivated to learn, grow and excel. Organized and dependable candidate successful at managing multiple priorities with a positive attitude.

Overview

7
7
years of professional experience

Work History

Claims Examiner- Life

Shelter Insurance Companies
Columbia, MO
11.2018 - Current
  • Determines validity of individual health claims in conformity with policy provisions and statutory requirements.
  • Reviews and analyzes claim documentation to determine coverage based on policy provisions, legal regulations, and investigation findings. Verifies coverage or benefits with medical providers, other companies, or government agencies.
  • Responds to individual health insurance inquiries regarding policy coverage, benefit amounts, and reasons for denial.
  • Processes health claim payments and recoveries.
  • Verifies explanation of benefit (EOB) documents.
  • Processes waiver of premium/waiver of monthly deduction claims and performs periodic reviews.
  • Provides administrative support for Claims Specialists as necessary.
  • Maintains vigilance for fraud or other abuses.


Records Management Specialist

Shelter Insurance Companies
Columbia, MO
09.2015 - 11.2018
  • Scanned paper documents into computer and assigned identification numbers to simplify tracking process.
  • Adhered to established procedures for handling sensitive and classified documents to retain chain of custody integrity.
  • Engaged in daily communications with internal partners and identified document-related issues that required interdepartmental cooperation.
  • Received and categorized incoming mail and claims information requests to begin document processing sequence.

Education

Biology

University of Missouri - Columbia
Columbia, MO

Skills

  • Superior tact, empathy, and communication skills
  • Maintains professionalism and confidentiality in all interactions
  • Ability to interpret and understand life and health policy provisions, medical records, tax laws, and legal documents
  • Strong attention to detail and high degree of accuracy in application of math skills
  • Ability to evaluate facts, exercise independent judgment, and make sound decisions based on product provisions, regulatory requirements, and company procedures
  • Ability to operate computer applications including mainframe, email and calendar, Internet basics, and document imaging
  • Ability to balance and prioritize multiple tasks

Timeline

Claims Examiner- Life

Shelter Insurance Companies
11.2018 - Current

Records Management Specialist

Shelter Insurance Companies
09.2015 - 11.2018

Biology

University of Missouri - Columbia

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Jillian Kenney