Jylesa Sanders
Mobile,AL
Summary
Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Commercial Claims Adjuster
Sedgwick Claims Management
Mobile, AL
05.2023 - Current
- Investigated commercial property claims, gathering facts and documents to determine coverage.
- Assessed damage and estimated costs for repairs or replacement of damaged items.
- Negotiated settlements with claimants in accordance with policy provisions.
- Negotiated and settled claims according to information presented through reports, research and data verification.
Auto Adjuster
Crawford
10.2022 - 01.2024
- Investigated vehicle damage, estimated repair costs and determined liability.
- Conducted research on state laws and regulations related to auto insurance claims.
- Analyzed accident reports, medical records and other documents to determine the extent of coverage.
- Negotiated settlements with claimants in an effort to reduce overall costs for the company.
- Provided customer service by responding to inquiries from policyholders regarding their claims status.
- Monitored payment schedules to ensure timely disbursement of funds.
Auto Adjuster
Pilot Catastrophe Services
Mobile, AL
08.2021 - 01.2022
- Investigated vehicle damage, estimated repair costs and determined liability.
- Conducted research on state laws and regulations related to auto insurance claims.
- Monitored payment schedules to ensure timely disbursement of funds.
- Researched and verified insurance policy coverage.
Unit Secretary
Mobile Infirmary Medical Center
Mobile, AL
03.2020 - 08.2021
- Greeted visitors and patients in a courteous and friendly manner.
- Maintained patient records, medical histories, test results and other pertinent information in the hospital's computer system.
- Assisted nursing staff with administrative tasks such as scheduling appointments, ordering supplies and preparing charts.
- Answered telephone calls promptly and directed them to appropriate personnel or departments.
- Provided clerical support including filing, faxing, photocopying and data entry of patient information into electronic health record systems.
- Prepared documents for signature by physicians or other authorized personnel.
- Responded to requests from internal staff regarding patient information in accordance with HIPAA regulations.
- Executed clerical tasks and assisted with unit duties to keep departments running smoothly.
Insurance Verification Specialist
GetixHealth
Mobile, AL
11.2019 - 05.2020
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
Billing Specialist
Miraca Life Sciences Inc.
Daphne, AL
03.2017 - 11.2019
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Answered customer inquiries regarding billings, payments, account status.
- Investigated incorrect billings and processed refunds as necessary.
- Processed credit card transactions through Point-of-Sale terminals or online systems.
Customer Service Representative
NCO Financial
Mobile, AL
02.2014 - 03.2017
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Answered inbound calls, chats and emails to facilitate customer service.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Inputted customer data into computer database accurately and quickly.
- Posted payments for insurance companies, including Medicare and Medicaid, by accurately entering data into the system.
- Processed incoming payments from patients and insurance companies in a timely manner.
Education
High School Diploma -
Williamson High School
Mobile05.2008
Skills
- Claims Processing
- Automobile Appraisals
- Medical Coding
- Advanced Computer Skills
- Cpt
- Epic
- CCC
- Mitchell
- Insurance verification
- ICD-10
- Hospital experience
- Medical experience
- Problem solving
- Critical thinking
Certification
State Farm Ceritified
USAA certified
Licensed in several states for adjusting
Custom
Clerical experience in the medical field
Timeline
Commercial Claims Adjuster
Sedgwick Claims Management
05.2023 - Current
Auto Adjuster
Crawford
10.2022 - 01.2024
Auto Adjuster
Pilot Catastrophe Services
08.2021 - 01.2022
Unit Secretary
Mobile Infirmary Medical Center
03.2020 - 08.2021
Insurance Verification Specialist
GetixHealth
11.2019 - 05.2020
Billing Specialist
Miraca Life Sciences Inc.
03.2017 - 11.2019
Customer Service Representative
NCO Financial
02.2014 - 03.2017
High School Diploma -
Williamson High School
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