Lanitra Gloston
Prairieville,LA
Summary
Motivated Insurance representative specializing in personal, property, medical and casualty loss and damages. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
19
19
years of professional experience
Work History
Sr. Medical Bill Review Rep
Louisiana Workers' Compensation Corporation
01.2014 - Current
- Maintain and review all required documentation for insurance coverage
- Reimbursement per guidelines of coverage and company policy, Helping clients make sure that they're paying the fair amount for the medical treatment of their injured employees, thus maximizing savings
- Working with Adjusters to make sure bills are paid on time and accurately
- Analyzed market to identify new opportunities and strengthen relationships with hospitals, medical centers and primary provider physicians.
- Conducted research to stay up-to-date with industry trends, prices and market competition.
- Safeguarded medical records and patient data in accordance with HIPAA protocols.
Auto Claims Adjuster
Allstate Corp
01.2012 - 01.2014
- Actively listen and use data to make liability decisions
- Pay all medical bills and time loss wages to the claimant
- Examined photographs and surveillance and any other documents relating to claims.
- Negotiated with claimants to settle claims.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
- Issued payouts to claimants.
- Documented all findings in concise reports.
- Determined salvage value on total-loss vehicle.
Insurance Claims Processor
Blue Cross Blue Shield
01.2010 - 01.2012
- Review new claims to determine coverage eligibility
- Send letters as needed to policyholders to update status of claims
- Review claim statuses to determine if additional actions are needed
- Responsible for accurate and timely processing of claims
- Assist with benefits and eligibility correspondence.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
Leader Intern
01.2008 - 01.2010
- With over five (5) years of management relief
- Experienced in employee development plans and strategic goal setting
- Very productive in fast-paced environments requiring multitasking abilitychallenging tasks
- Tracked customer service representative complaint handling data and developedreports for management review
- Coordinated skip level meetings for management
- Noted for excellent skills regarding customer inquiry resolution within multiplebusiness units.
Customer Service Representative
AT&T
01.2003 - 01.2007
- Responded to customer/client requests or inquiries concerning services, products,billing, equipment, claims, and reports problem areas
- Experienced in multiple queues/skill sets over various customer contact channels
- Processed customer payments for wireless bills and accessories
Education
Bachelor of Science - Economics
Southern University And A&M College
07.2001
Skills
- COMPUTER SKILLS
- Microsoft Office, GWAM (45), Smart Advisor, Lagniappe, Outlook email
- Professional Relationships
- Persuasive Communication
- Knowledgeable about Diseases
- Customer Education
- Medical Coverage
- Claims Adjustments
- Collaborative Team Work
- Office Equipment
- Customer Service and Assistance
- Health Care System
Timeline
Sr. Medical Bill Review Rep
Louisiana Workers' Compensation Corporation
01.2014 - Current
Auto Claims Adjuster
Allstate Corp
01.2012 - 01.2014
Insurance Claims Processor
Blue Cross Blue Shield
01.2010 - 01.2012
Leader Intern
01.2008 - 01.2010
Customer Service Representative
AT&T
01.2003 - 01.2007
Bachelor of Science - Economics
Southern University And A&M College
Similar Profiles
Jason AllemanJason Alleman
Network Administrator at Louisiana Workers' Compensation CorporationNetwork Administrator at Louisiana Workers' Compensation Corporation
Andrea SluggettAndrea Sluggett
Strategic and Corporate Reporting Analyst at Workers Safety and Compensation CommissionStrategic and Corporate Reporting Analyst at Workers Safety and Compensation Commission
Edwin E. FloresEdwin E. Flores
Claims Examiner (GS-12) at Department Of Labor - Office Workers CompensationClaims Examiner (GS-12) at Department Of Labor - Office Workers Compensation
Deziree EdwardsDeziree Edwards
Material Expeditor at Cajun Constructors Inc.Material Expeditor at Cajun Constructors Inc.
Stephen FugarinoStephen Fugarino
Delivery Driver at The Advocate NewspaperDelivery Driver at The Advocate Newspaper