Leslie Delgado
San Antonio
Summary
Detail-oriented Medbill Examiner with a proven track record in claims analysis and regulatory compliance. Skilled in effective communication and risk assessment to ensure accuracy in claims processing.
Overview
1
1
Language
3
3
years of professional experience
Work History
Medbill Examiner III
The Hartford Insurance Group
San Antonio
09.2025 - Current
- Reviewed and analyzed claims for accuracy, completeness of medical records, and compliance with policy terms to ensure proper claims processing.
- Evaluated insurance claims for accuracy and compliance with company policies.
- Determined if claims were valid according to established rules and regulations.
- Reviewed and analyzed policy documents to determine coverage eligibility.
- Collaborated with adjusters to gather necessary documentation for claims processing.
- Investigated inconsistencies in documentation or reports from third parties to uphold integrity of claims evaluation.
- Recommended actions based on review findings, determining eligibility for denial or approval of benefits payments.
- Maintained accurate records of examined claims in the company database.
- Adhered strictly to company standards when evaluating cases for payment authorization.
- Maintained accurate files containing all relevant documents pertaining to each claim.
- Participated in training sessions designed to update staff on changes in laws governing insurance policies.
Underwriting Service Assistant
The Hartford Insurance Group
San Antonio
04.2023 - 09.2025
- Assisted underwriters with risk assessment and policy evaluations.
- Reviewed and processed applications, documentation, and other pertinent information to ensure accuracy.
- Evaluated new applications for completeness and accuracy while ensuring compliance with company policies.
- Reviewed applications to ensure compliance with company standards.
- Processed underwriting documents for accuracy and completeness.
- Identified any inconsistencies between documents submitted by customers and existing records.
- Maintained organized records of policy submissions and approvals.
- Maintained up-to-date records of all underwriting activities in accordance with established procedures.
- Coordinated communication between clients and underwriting teams.
- Managed correspondence with agents regarding policy inquiries.
- Performed detailed analysis of customer accounts in order to identify potential risks or discrepancies in coverage.
- Developed strategies for mitigating risks associated with certain types of transactions.
- Performed research to enhance decisions regarding risk assessment.
- Collected and reviewed third-party reports to support decisions.
- Monitored changes in industry regulations and took appropriate action when necessary.
- Performed due diligence by assessing data.
- Maintained positive working relationship with fellow staff and management.
- Maintained positive working relationship with fellow staff and management.
Education
Associate of Applied Science - Health Care Administration
The College of Health Care Professions
TX07-2021
Skills
- Claims analysis
- Claims processing
- Claims evaluation
- Claims handling
- Claims documentation
- Documentation review
- Policy compliance
- Regulatory adherence
- Risk assessment
- Healthcare regulations
- Records evaluation
- Analytical skills
- Analytical thinking
- Attention to detail
- Time management
- Problem solving
- Organizational skills
- Effective communication
- Customer relationship management
Languages
Spanish
Professional
Timeline
Medbill Examiner III
The Hartford Insurance Group
09.2025 - Current
Underwriting Service Assistant
The Hartford Insurance Group
04.2023 - 09.2025
Associate of Applied Science - Health Care Administration
The College of Health Care Professions