Highly motivated and detailed-oriented individual with a strong foundation proven ability to learn quickly and adapt to new challenges. Strong communication, organizational, and problem-solving skills to contribute effectively to a dynamic team environment. Dedicated and results-driven professional. Enthusiastic and resourceful individual with a strong work ethic.
Work History
Licensed Claims Adjuster
3 Years 8 Months
State Farm | 10.2022 - Current
Masterfully navigated the intricate landscape of total loss claims, ensuring every resolution adhered to stringent state regulations and company directives.
Deciphered true vehicle valuations with precision, leveraging industry-leading platforms like CCC One to secure equitable outcomes.
Cultivate trust and clarity through compelling communication, guiding policyholders and stakeholders seamlessly through complex total loss scenarios.
Orchestrated the swift and meticulous progression of a high-volume claim portfolio, from initial notification to conclusive settlement, with unwavering attention to detail.
Executed precise financial disbursements, ensuring every claim payment was processed with impeccable accuracy and within regulatory frameworks.
Project Manager
5 Years 10 Months
Magellan Health | 11.2016 - 09.2022
Spearheaded critical initiatives to bridge communication gaps across diverse segments, cultivating a seamless operational "assembly line"
End-to-end project lifecycles from strategic inception and stakeholder alignment to execution and post-implementation review, consistently delivering impactful solutions.
Robust cross-functional collaboration, uniting disparate teams and departments to drive shared objectives and optimize project outcomes.
Developed and Implemented innovative communication strategies, ensuring clarity, transparency, and timely information exchange to accelerate decision-making and mitigate risks.
Quality Assurance Analyst
4 Years 10 Months
CVS Caremark | 01.2012 - 11.2016
Directed units of coders and testers, meticulously refining claim adjudication processes to unlock peak operational performance and ensure data accuracy.
Established and enforce quality frameworks, validating the integrity of all coding and testing to guarantee deployment of critical client systems.
Precise and Seamless delivery of pharmacy benefits for a diverse portfolio of enterprise clients, reliable support.
Comprehensive documentation, ensuring detailed notes and records were maintained for all processes, findings, and resolution.
Education
High School Diploma
Maricopa Community Colleges, Glendale Community College | Glendale, AZ
High School Diploma Mountain Pointe High School Phoenix,AZ
May 2007
Participated in Student Government, Debate Club
Skills
Claims investigation
Policy interpretation
Insurance regulations
Customer service
Centers for Medicare and Medicaid Services (CMS)
SQL
MS Office
Quality Assurance
Supervision
Timeline
Licensed Claims Adjuster
State Farm
10.2022 - CurrentRead More
Project Manager
Magellan Health
11.2016 - 09.2022Read More
Quality Assurance Analyst
CVS Caremark
01.2012 - 11.2016Read More
Maricopa Community Colleges, Glendale Community College