Jinyi Kim
Sedgwick Claims Management Services Inc.
Dallas,TX
Work Preference
Job Search Status:
Open to work
Work Type
Full TimePart TimeContract Work
Location Preference
RemoteHybrid
Open to relocation:
No
Minimum Desired Compensation
$55000/yr
10
Years of experience
Dynamic and versatile professional with a proven track record in claims management, supported by extensive experience across wholesale, retail, and finance sectors. Analytical thinker with exceptional communication skills, recognized for a collaborative approach to teamwork and the ability to adapt swiftly to new environments while thriving under pressure. Committed to driving team success while continuously improving professional capabilities. Known for maintaining a positive mindset and unwavering dedication to lifelong learning and personal development.
Work History
Workers' Compensation Claims Representative
11 Months- Analyzed and evaluated medical-only and minor lost-time workers' compensation cases to determine compensability and benefits due, while ensuring compliance and ongoing adjudication of claims within company standards and industry best practices.
- Facilitated prompt communication of claim actions with claimants, clients, and medical partners to enhance overall claim management.
- Optimized claim file accuracy through diligent management of documentation, financial reserves, and medical coding and billing updates.
- Streamlined payment processing, prescription requests, and scheduling of medical appointments for injured claimants, resulting in improved client satisfaction.
- Assisted in the resolution of larger more complex claims undertaking additional responsibilities as necessary leading to increased operational efficiency.
Liability Claims Representative
1 Year 1 Month- Processed and managed daily high-volume caseloads for general liability and property damage, ensuring compliance with client specific service expectations, regulatory guidelines and industry best practices.
- Analyzed documentation, reviewed evidence, and conducted thorough investigations to determine coverage eligibility, claim validity and liability exposures.
- Collaborated with field teams and contractors to accurately assess damages and determine repair costs, facilitating timely resolutions and effective settlement negotiations.
- Streamlined additional areas of workflow by implementing process improvements that enhanced operational efficiency and reduced claim processing times overall.
Claims Assistant
1 Year- Provided comprehensive claims support to the workers' compensation and liability teams to ensure accurate processing and adjustment of claims for multiple client-specific programs.
- Achieved timely processing of new claims by inputting data and reviewing documentation for accuracy. Maintained a consistent daily caseload of 30 to 80 claims, resulting in a targeted 24-hour turnaround.
- Effectively handled communication of pertinent claim information to the client, legal counsel, medical, rehab providers, and internal claims staff, providing customer service as required.
- Facilitated the efficient preparation and distribution of letters, reports, benefit notices, labels, and forms, enhancing overall communication effectiveness.
- Streamlined in-office operations by overseeing mail management, document filing, communication faxing, material sorting, and file organization.
- All other administrative activities and projects as assigned, in addition to the general maintenance of long term storage solutions of claims evidence and files.
Account Manager, Inside Sales
1 Year 3 Months- Business-to-business inside sales role responsible for selling a diversified range of Telecom, Data-com, Data Center, and CCTV/Access Control products serving the Network and Security Solutions (NSS) market, delivering leading product solutions and technical expertise that met or exceeded customers' demands today and in the future.
- Achieved successful account development through effective prospecting, generating sales quotes, and resolving customer inquiries, contributing to improved customer service, overall satisfaction and business expansion.
- Executed cold and warm calls for innovative market initiatives while acquiring in-depth technical knowledge of data communication products and vendors.
- Advanced business development activities within a variety of markets dedicated to providing tailored infrastructure solutions across the globe.
A/P, A/R, Commercial Collections & Billing
1 Year 4 Months- Commercial Collections: Daily responsibilities included contacting and resolving multiple delinquent accounts ranging in the $12-$15 mil portfolio, handling all invoicing, using D&B reports and setting new and adjusted credit lines.
- Accounts Receivable: Solely responsible for all daily cash management activity, including the recording, depositing and reconciliation of incoming fund transfers for two separate entities / intercompany books. Revenue consistently exceeding $100k up to $1.5M+.
- Accounts Payable: Daily resolution of complex accounts payable inquiries; including extensive research, analyzing factual data, completing thorough reviews of supplier statements, consistently providing prompt assistance on all supplier and site location requests and the escalation of unresolved issues to management early and often always providing timely customer service to internal and external partners.
Education
Pharmacy Technician Certification Program
High School Diploma
Skills
- Claims Processing & Management
- Workers Compensation
- Property & Liability Claims
- Accounts Payable
- Accounts Receivable. Commercial Collections
- Corporate Accounting & Billing
- Customer Service / Multi-Line Phone Operations
- Filing
- Database & Records Management
- Clerical & Administrative Support
- Negotiation & Dispute Resolution Experience
- Data Entry
- 10-key by Touch
- 60+ WPM
Timeline
Workers' Compensation Claims Representative
Sedgwick Claims Management Services Inc.
10.2023 - 09.2024Read More
Liability Claims Representative
Sedgwick Claims Management Services Inc.
09.2022 - 10.2023Read More
Claims Assistant
Sedgwick Claims Management Services Inc.
09.2021 - 09.2022Read More
Account Manager, Inside Sales
Anixter Inc.
03.2016 - 06.2017Read More
A/P, A/R, Commercial Collections & Billing
Contract Positions
11.2014 - 03.2016Read More
Brookhaven College
Pharmacy Technician Certification Program
Read More
Newman Smith High School
High School Diploma
Read More
Languages
Korean
Limited Working