Leslie Dukes
Detroit,MI
Summary
Accomplished Senior Governmental Physicians Insurance Collector and Excess Loss Claims Specialist with Rush Health Systems and Key Benefit Administrators, respectively. Expert in insurance industry knowledge and critical thinking, achieving significant improvements in client satisfaction and compliance. Excelled in relationship building and analytical skills, driving effective solutions and enhancing operational efficiency.
Overview
31
31
years of professional experience
Work History
Senior Governmental Physicians Insurance Collector
Rush Health Systems
Meridian, MS
05.2000 - 06.2018
- Researched billing errors and discrepancies to initiate corrective action.
- Analyzed client records for accuracy before initiating contact, ensuring an informed approach when discussing outstanding balances.
- Entered client details and notes into system for interdepartmental access and review.
- Developed a comprehensive understanding of state-specific regulations governing insurance collections, ensuring compliance with legal requirements in all interactions with clients.
- Assisted in training new employees on best practices for insurance collections, contributing to overall team success.
- Fostered a positive work environment through collaboration, professional development opportunities, and open communication channels among colleagues in the Insurance Collections Department.
- Applied critical thinking skills to identify potential issues and proactively implement effective solutions, minimizing disruptions to the collections process.
- Enhanced client relationships by providing exceptional service throughout the collections process.
- Coordinated with other departments to resolve disputes and streamline interdepartmental processes related to insurance collections.
- Maintained accurate records of all client interactions, ensuring timely follow-up on promises to pay and streamlining future collection efforts.
Excess Loss Claims Specialist
Key Benefit Administrators
Fort Wayne, IN
11.1987 - 06.1999
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Delivered comprehensive training sessions for new hires on claims handling procedures, policy interpretation basics, negotiation techniques, and other core competencies related to the role of a Claims Specialist.
- Achieved performance targets consistently through attention to detail, effective time management, and strong decision-making abilities.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Maintained accurate records by diligently updating claim files and ensuring all required documentation was submitted in a timely manner.
- Collaborated closely with underwriting teams to ensure appropriate risk assessment measures were applied during policy issuance.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Checked documentation for accuracy and validity on updated systems.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Generated, posted and attached information to claim files.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Education
Diploma - Medical Receptionist/Office Assistant
Lafayette Academy Inc
HomeStudy, Detroit, MI09.1975
High School Diploma -
Cass Technical High School
Detroit, MI06.1971
Skills
- Follow-up Techniques
- Strong negotiation skills
- Goal-oriented mindset
- Data entry proficiency
- Insurance industry knowledge
- Assertiveness
- Attention to Detail
- Updating Customer Accounts
- Organizational Skills
- Decision-Making
- Relationship Building
- Microsoft Office
- Documentation and Recordkeeping
- Analytical and Critical Thinking
- Customer Relationship Management
- Pleasant Telephone Demeanor
- Training and Teaching
- Paperwork Processing
- Payment Processing
- Managing Delinquent Accounts
- Clear Communication
- Account Monitoring
- Basic Mathematics
- Insurance Company Communication
- Quality Standards Compliance
- Service Quality Standards
- Audit Procedures
- Codes reviewing
- Correspondence Writing
- Aging reports analysis
- Financial Documentation
- Investigative research
- Accurate payment posting
Timeline
Senior Governmental Physicians Insurance Collector
Rush Health Systems
05.2000 - 06.2018
Excess Loss Claims Specialist
Key Benefit Administrators
11.1987 - 06.1999
Diploma - Medical Receptionist/Office Assistant
Lafayette Academy Inc
High School Diploma -
Cass Technical High School