La'Tara Rivers
Irving,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Claim Associate
State Farm Mutual Automobile Insurance Company
Richardson, TX
04.2022 - Current
- Assisted new policyholders with processing claims.
- Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
- Performed data entry functions into the computer system accurately and efficiently.
- Verified claim data correctness in preparation for processing.
- Maintained up-to-date knowledge of industry trends, policies and procedures related to claims processing.
- Collaborated with fellow team members to manage large volume of claims.
- Reviewed and processed incoming documents to ensure accuracy of information.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Collaborated with appraisers, facility managers, body shops and salvage vendors.
- Built rapport and trust with injured insureds through effective customer service techniques which involved fair and prompt processing of claims.
- Corresponded with insured or agent to obtain information or inform of account status or changes.
- Addressed customer inquiries to provide information and explanations on coverage and terms, expediting claims.
- Signed payment approvals accepted claims.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Analyzed customer inquiries to determine the appropriate course of action for claims resolution.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Identified needs of customers promptly and efficiently.
- Exceeded customer satisfaction by finding creative solutions to problems.
- Maintained updated knowledge through continuing education and advanced training.
- Displayed strong telephone etiquette, effectively handling difficult calls.
Intake Coordinator
WebTPA
Irving, TX
11.2021 - 04.2022
- Maintained accurate records of client intakes in electronic database system.
- Coordinated the intake process for new clients, including scheduling initial assessments and providing necessary paperwork.
- Resolved customer complaints or answered customers' questions.
- Adhered to confidentiality guidelines when handling sensitive information about clients.
- Answered phone calls to provide assistance, information and medical personnel access.
- Conducted patient intake interviews to collect medical information and insurance details.
- Understood and followed oral and written directions.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Prioritized and organized tasks to efficiently accomplish service goals.
Patient Care Advocate
AllianceRx Walgreens Prime
Dallas, TX
09.2016 - 10.2021
- Developed strong and trusting rapport with patients to facilitate smooth, quality care.
- Monitored changes in patient status and reported any concerns or issues to the primary care team for prompt resolution.
- Acted as liaison for hospital staff, physicians, patients and family members.
- Provided knowledgeable and compassionate service in response to patient questions and concerns.
- Actively sought feedback from patients about their experiences within the healthcare system in order to improve service delivery models.
- Managed database of patient information and frequently used computerized systems to track details.
- Coordinated with other healthcare providers to ensure patient safety, continuity of care, and optimal outcomes.
- Maintained accurate documentation of all interactions with patients in accordance with HIPAA regulations.
- Obtained informed consent and payment documentation from patients and filed in system.
- Collaborated with insurance companies to ensure coverage of necessary treatments or medications.
- Helped patients understand care, coverage and payment responsibilities and rights.
- Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
- Analyzed accuracy and completeness of patient documents such as insurance claims, medical bills and legal paperwork.
- Identified needs of customers promptly and efficiently.
- Maintained updated knowledge through continuing education and advanced training.
- Assisted with customer requests and answered questions to improve satisfaction.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Caregiver
Harbor Chase Senior Living
Southlake, TX
08.2019 - 08.2020
- Maintained clean and well-organized environment for client happiness and safety.
- Worked closely with clinical staff to support therapeutic and behavioral plans.
- Respected the rights of each individual client while maintaining confidentiality of all personal information.
- Built strong and trusting rapport with clients and loved ones.
- Followed safe lifting and transferring techniques to transport residents.
- Monitored health and well-being of clients and reported significant health changes.
- Improved patient outlook and daily living through compassionate care.
- Observed patients for changes in physical, emotional, mental or behavioral condition and injuries.
- Assisted with ambulation by providing support during transfers from bed to chair or wheelchair.
- Recorded client status progress and challenges in logbooks and reports.
- Performed light housekeeping tasks related to the client's care such as laundry and changing linens.
- Observed changes in behavior or physical condition that may require medical attention and reported them promptly to supervisor.
- Maintained cleanliness of clients' environment by cleaning surfaces and washing clothes or dishes.
- Supported bathing, dressing and personal care needs.
- Maintained detailed records of services performed on clients.
- Created safe and positive living situations for clients by communicating with family and other staff about concerns or challenges.
- Provided emotional support for clients who were experiencing depression or anxiety due to their illness or disability.
Member Service Specialist
Teladoc
Lewisville, TX
08.2016 - 06.2018
- Researched discrepancies on member accounts and resolved issues promptly and accurately.
- Monitored trends in customer feedback in order to identify areas needing improvement within the organization.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Updated databases with new and modified customer data.
- Developed relationships with members to increase loyalty and satisfaction through personal contact, follow-up calls, and outreach activities.
- Answered inbound calls from wide range of members, welcoming callers.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Completed day-to-day duties accurately and efficiently.
- Recognized by management for providing exceptional customer service.
Education
Associate in Occupational Studies - Medical Assisting
Career Technical College
Monroe, LA04.2002
Skills
- Claims Review
- Small Claims Payouts
- Customer Service
- Data Entry
- Teamwork and Collaboration
- Microsoft Office
- Understanding of Medical Terms
- Payment and Investigation Escalations
- Decision-Making
- 10-Key Touch
- Documentation Skills
- Documentation Abilities
- Organizing and Prioritizing Work
- Critical Thinking
- Active Listening
- Medical Terminology
- Attention to Detail
- Claims Processing
- Damage Mitigation
- Liability Determination
- Team Collaboration
- Team Training
- Computer Skills
- Property Claims
Accomplishments
- Subrogation SPOC for my team
August 2023 - Present
Increase team's awareness of the importance of Subrogation by providing weekly sub results, providing one on one training when needed to enhance the knowledge in recognizing SUB opportunities are present and how my teammates can use available resources such as ISO/OIC TOOL, boost team morale by sending weekly reminders such as tips and encouragement when seeking SUB recovery potential and ongoing engagement with SUB competition to aid in increased SUB recovery potential
Certification
- Property & Casualty adjuster's licensure for various states
References
References available upon request.
Timeline
Claim Associate
State Farm Mutual Automobile Insurance Company
04.2022 - Current
Intake Coordinator
WebTPA
11.2021 - 04.2022
Caregiver
Harbor Chase Senior Living
08.2019 - 08.2020
Patient Care Advocate
AllianceRx Walgreens Prime
09.2016 - 10.2021
Member Service Specialist
Teladoc
08.2016 - 06.2018
Associate in Occupational Studies - Medical Assisting
Career Technical College
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