LYLA GROSSMAN
Great Falls,MT
Summary
Results-driven Senior Claims Adjuster with extensive experience at Broadspire, adept at evaluating complex claims and ensuring compliance. Proven ability in decision-making and active listening, enhancing team performance through mentorship. Skilled in quality control and collaboration, consistently achieving accurate claim resolutions and improving processes.
Overview
41
41
years of professional experience
Work History
Senior Claims Adjuster
Broadspire
Great Falls, MT
09.2012 - 02.2020
- iEvaluated complex claims to determine liability and coverage in accordance with policy guidelines.
- Conducted thorough investigations, gathering evidence and statements to support claim decisions.
- Collaborated with legal teams to analyze documentation and resolve disputes effectively.
- Mentored junior adjusters, enhancing team capabilities through training on best practices and policies.
Claims Examiner
Blue Cross Blue Shield of MT
Great Falls, MT
02.1979 - 09.2012
- Evaluated claims for accuracy and compliance with policy guidelines.
- Collaborated with healthcare providers to resolve discrepancies in claims submissions.
- Reviewed medical documentation to ensure proper coding and billing practices.
- Trained junior staff on claims processing procedures and best practices.
Education
High School Diploma -
Great Falls High School
Great Falls, MT06-1978
Skills
1Active listening
Highly motivated
Team collaboration
Decision-making
Quality control
Timeline
Senior Claims Adjuster
Broadspire
09.2012 - 02.2020
Claims Examiner
Blue Cross Blue Shield of MT
02.1979 - 09.2012
High School Diploma -
Great Falls High School