Kaysoniee Watson
Tallahassee,FL
Summary
Responsible Senior Claims Examiner with experience performing detailed investigations and researching issues. Skilled at interpreting laws, evaluating facts, inspecting damage and analyzing case facts. Handles 20000 claims per day and provides exceptional customer service to clients and employees.
Overview
13
13
years of professional experience
Work History
Claims Examiner 2
HealthEquity
04.2014 - 05.2023
- Examined photographs and statements.
- Researched claims and incident information to deliver solutions and resolve problems.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Reviews and processes employee benefits claims including but not limited to flexible spending accounts (health care, dependent care, and card verifications), tuition assistance, adoption reimbursement, transit and parking programs, and health reimbursement accounts following standard operating procedures.
- Successfully completes training in the customer service role and serves as back up support for the customer service department, based on business needs. Maintains knowledge and skills on a continuing basis to effectively respond to customer calls.
- Logs and records information about claims cases and/or applicable research by inputting information into company systems and updating information in a timely and accurate manner.
Claims Examiner 1
HealthEquity
03.2010 - 04.2014
- Interviewed claimants and to gather factual information.
- Approve or reject request in accordance with client and IRS regulations
- Researched claims and incident information to deliver solutions and resolve problems.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Provide optimal service to providers, benefits administrators, and employers while identifying fradulent claims
Administrative Assistant
Florida Department Of Health
01.2010 - 11.2010
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Resolves administrative problems by coordinating reports, providing travel arrangements, and providing contract management.
- Updated information on Bureau of HIV/AIDS website.
- Review AIDS formulary suggestions and sent recommendations to Medical Director.
- Provide a central location to track and report status of all medical projects.
Education
Associate of Science - Business Economics
Florida Agricultural And Mechanical University
Tallahassee, FLSkills
- Report and Records Review
- Confidential Records Management
- Claims Handling and Processing
- Account Management
- Policy Interpretation
- Customer Service
Timeline
Claims Examiner 2
HealthEquity
04.2014 - 05.2023
Claims Examiner 1
HealthEquity
03.2010 - 04.2014
Administrative Assistant
Florida Department Of Health
01.2010 - 11.2010
Associate of Science - Business Economics
Florida Agricultural And Mechanical University
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