Summary
Overview
Work History
Education
Skills
Accomplishments
Awards
Languages
Timeline
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Lavinia J. Chong

Summary

Experienced professional in health, care, and auto claims processing with a proven track record in management. Solid background in customer service and administrative support. Prepared to thrive in a fast-paced insurance environment. Possesses a natural aptitude for swiftly grasping industry-specific software and regulatory guidelines, enabling seamless adaptation to new systems and processes. Strong commitment to communication and problem-solving. Eager to utilize and further develop these skills within my role.

Overview

12
12
years of professional experience

Work History

Insurance Account Specialist

Patient First
03.2023 - 03.2024
  • Evaluated medical claims for accuracy and completeness and researched missing data.
  • Verified patient insurance coverage and benefits for medical claims.
  • Assessed medical claims for compliance with regulations and corrected discrepancies.
  • Followed up on denied claims to verify timely patient payment and resolution.
  • Identified trends in denied claims and implemented corrective actions, increasing overall approval rates.
  • Managed high-volume caseloads while maintaining strict attention to detail in order to ensure successful processing of each individual claim submission.
  • Responded to correspondence from insurance companies.
  • Collaborated with healthcare insurance providers to obtain necessary documentation, ensuring timely and accurate claim submissions.
  • Maintained updated knowledge of industry regulations and guidelines, resulting in fewer claim denials or rejections.

Supervisor/Claims Adjuster

GEICO
04.2017 - 10.2021
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
  • Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
  • Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
  • Implemented rewards and recognition program that significantly increased employee engagement and satisfaction.
  • Verified insurance claims and determined fair amount for settlement.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
  • Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
  • Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
  • Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
  • Negotiated bodily injury settlement agreements to resolve disputes.

Business Office Associate

NYU Langone Medical Center
01.2012 - 03.2017
  • Handled account payments and provided information regarding outstanding balances.
  • Managed invoicing and payment processing operations.
  • Verified accuracy of billing data and corrected discrepancies.
  • Verified insurance coverage to confirm patient coverage for necessary medical services.
  • Increased patient satisfaction by effectively communicating with patients regarding their coverage, benefits, and anticipated out-of-pocket expenses.
  • Upheld data integrity standards by meticulously entering pertinent information into electronic health records systems during the authorization process.
  • Communicated with insurance companies to obtain pre-authorizations for treatment.

Education

MBA - Business Administration and Management

University of Phoenix
Phoenix, AZ
12.2019

Skills

  • Management Experience
  • Electronic Medical Records
  • Claims Processing
  • Health Insurance Coverage
  • Customer service

  • Written and oral communication
  • LiveChat
  • Team building
  • Training and mentoring

Accomplishments

  • Supervised a team of 10 staff members.
  • Customer Relations - Earned the highest marks for company-wide customer satisfaction.
  • Achieved shorter call handling times by creating a tip sheet in Microsoft OneNote.

Awards

  • Most Improved Team, My team increased their CSS score by 15% in a month
  • 5 Star Customer Service Survey, I received this award 6 times in a row.
  • Accelerated Supervisor, I joined the supervisor prep team and was promoted to supervisor within 3 months.
  • Team Player Award, For three weeks I supervised 4 teams of 10 associates.

Languages

Spanish
Native or Bilingual

Timeline

Insurance Account Specialist

Patient First
03.2023 - 03.2024

Supervisor/Claims Adjuster

GEICO
04.2017 - 10.2021

Business Office Associate

NYU Langone Medical Center
01.2012 - 03.2017

MBA - Business Administration and Management

University of Phoenix
Lavinia J. Chong