Lynn Wilson-Bruce
Summary
Dynamic Claims Representative at Sedgwick, recognized for excellence in claims processing and exceptional customer service. Strong communication and relationship-building skills enhance client satisfaction while streamlining workflows, resulting in increased operational efficiency. Proficient in claims investigation and documentation research, ensuring compliance and facilitating timely resolutions. Committed to delivering high-quality service and fostering positive client relationships in a fast-paced environment.
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering 5 years of insurance experience.
Overview
19
19
years of professional experience
Work History
Claims Representative
Sedgwick
03.2023 - 03.2025
- 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.
Claims Representative
Sedgwick
03.2023 - 03.2025
- 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.
Work Comp Adjuster
CorVel
02.2021 - 03.2023
- 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.
Work Comp Coordinator
OrthoKansas
08.2018 - 02.2021
- 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.
- Scheduled appointments and surgeries in a timely manner, communicating with adjusters, nurse case managers and providers but mostly the injured worker.
- 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 case.
- 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.
Patient Accounts Billing Representative
Lawrence Memorial Hospital
04.2006 - 08.2018
- Consulted with patients to discuss unpaid claims and reviewed findings 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.
Education
High School -
Eudora High School
Eudora, KansasSkills
- Proficient in Microsoft Office
- Insurance claims review
- Claims assessment
- Effective time management
- Flexible schedule
- Documentation research
- Collaborative teamwork
- Focused listening
- Detail-oriented approach
- Service excellence
- Claims processing
- Records management
- Claims adjustment
- Detail-oriented data management
- Clear interpersonal communication
- Trustworthy execution
- Skilled in prioritizing concurrent responsibilities
- Effective communication
- Adaptability and flexibility
- Collaborative skills
- Clear and concise communication
- Collaborative networking abilities
- Commitment to professional standards
- Proactive self-starter
Timeline
Claims Representative
Sedgwick
03.2023 - 03.2025
Claims Representative
Sedgwick
03.2023 - 03.2025
Work Comp Adjuster
CorVel
02.2021 - 03.2023
Work Comp Coordinator
OrthoKansas
08.2018 - 02.2021
Patient Accounts Billing Representative
Lawrence Memorial Hospital
04.2006 - 08.2018
High School -
Eudora High School
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