Lynn Wilson-Bruce

• Worked productively in fast-moving work environment to process large volumes of claims.
• Followed up with customers on unresolved issues.
• Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
• Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
• Developed strong relationships with clients, facilitating trust and open communication during the claims process.
• Enhanced claim processing efficiency by streamlining workflows and implementing best practices.

• Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
• Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
• Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
• Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.

Reviewed all the injured workers who sought care at our Orthopedic office. Managed and handled 50-60 injured workers a month, reviewing accident reports, coordination with medical records and scheduling designated physician appointments. Schedule appointments and surgeries in a timely manner, communicating with adjusters, nurse case managers and providers but mostly the injured worker. It was important to me they felt they had someone in their corner. Provided email correspondences, professional telephone interactions and daily activity reports with injured workers, employers, adjuster and nurse case managers to ensure accurate info and appropriate medical services. Handled impairment rating results. I was a huge advocate for offering compassion, answering inquires and authorizing services, scheduling appointment and addressing company issues. I helped increased revenues by restoring relationships with adjusters, case managers and company human recourses manager to obtain a new work comp cases. Produced high patient satisfaction levels by providing daily communication with new and existing patients. Strengthened relations with injured workers by providing post physician meeting to discuss and answer question regarding the work comp process.

• Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
• Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
• Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.

Consulted with patients to discuss unpaid claims and reviewed finding with insurance companies to ensure timely payments. Enhanced members knowledge of insurance and medical bills, work comp claims, auto claim by providing education and accurate information. Advocated for patients and the hospital by reviewing payments of unpaid claims.

I also helped in the ER as an admission clerk when they were shorthanded. I was able to use my customer service skills when getting the patient admitted.

• Reviewed and solved account and billing discrepancies.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Coordinated with intermediate parties to obtain payments and resolve issues.
• Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.