Macie Macedo
Carson City,NV
Summary
Professional with focus on claims evaluation and resolution. Adept at analyzing complex information, negotiating settlements, and ensuring compliance with regulations. Known for strong teamwork and adaptability, driving results in fast-paced environments. Skilled in customer communication, conflict resolution, and decision-making. Positive, reliable with a detail-oriented and systematic approach, Looking to tackle challenges efficiently with a company that values a strong work ethic.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Only Claims Adjuster
Associated Risk Management, INC.
Carson City, NV
03.2025 - Current
- Evaluate and process workers' compensation claims to ensure compliance with regulations.
- Collaborate with medical professionals to assess injury impacts and validate claims.
- Maintain compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Conducted thorough investigations, interviewing relevant parties to substantiate claims accuracy and validity.
Claims Assistant
Associated Risk Management, INC.
Carson City, NV
04.2023 - 03.2025
- Assisted claimants, medical providers, employers, and attorneys with problems or questions regarding claims.
- Updated claim notes as needed throughout the life cycle of a case file.
- Gathered and organized medical records, and other documentation, to support claim decisions.
- Coordinated scheduling for claimants with physicians across various specialties, balancing patient needs, and doctor availability.
- Requesting the appropriate medical documentation efficiently and in accordance with HIPAA regulations.
- Handled sensitive information in accordance with company policy and HIPAA regulations.
- Completed day-to-day duties accurately and efficiently.
- Communicated effectively with supervisors regarding any issues that arose during the course of handling a case file.
- Collaborated with fellow team members to manage large volume of claims.
Index Clerk
Associated Risk Management, INC.
Carson City, NV
07.2022 - 03.2023
- Performed data entry tasks accurately and efficiently.
- Developed methods to improve efficiency while maintaining accurate records.
- Updated existing indexes and created new ones when necessary.
- Scanned hard copy documents into electronic format for storage in database systems.
- Maintained records of all incoming and outgoing documents, ensuring accuracy and completeness.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Provided assistance to other departments by locating requested information from the index system.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Resolved discrepancies between physical files and digital records through investigation and analysis.
File Clerk
Associated Risk Management, INC.
Carson City, NV
03.2022 - 07.2022
- Managed and organized physical and digital filing systems for easy access and retrieval.
- Located missing records by searching files or contacting individuals assigned to records.
- Scanned or read incoming materials to determine classification or filing.
- Consolidated outdated files to inactive storage, following guidelines and legal requirements.
- Retrieved requested files and delivered to appropriate personnel.
- Responded to requests for file retrieval, ensuring timely and accurate access to documents.
- Prepared labels for new files and folders as needed.
- Classified information into chronological, alphabetical, or numerical order.
- Sorted or classified information according to content, purpose or user criteria.
- Pulled files for staff and management when requested.
- Scanned documents into electronic database system for archiving purposes.
Mail Clerk / Front Office Receptionist
Associated Risk Management, INC.
Carson City, NV
01.2022 - 03.2022
- Answered multi-line phone system and managed calls by routing to proper extensions or taking messages.
- Created and managed digital and physical filing systems for records, correspondence, and other material.
- Received, sorted and organized incoming letters and packages.
- Provided administrative support including photocopying, faxing, and filing.
- Handled sensitive information in a confidential manner.
- Preserved office security by following safety procedures and controlling access via reception desk.
- Signed for packages, recorded deliveries and distributed to personnel.
- Coordinated the pickup and delivery of express mail services (e.g., FedEx, UPS).
Crew Lead
McDonald's
Turlock, CA
03.2020 - 12.2021
- Provided guidance and support to team members in order to ensure successful completion of tasks.
- Trained new hires on job responsibilities, safety protocols, and company policy.
- Acted as a liaison between crew members and management, facilitating open communication.
- Established and maintained professional working relationships with employees.
- Worked productively as lead or helping team member to drive customer satisfaction.
- Assigned work duties, monitored workflow, and evaluated results.
- Maintained high standards of customer service during peak hours.
- Monitored task completion to meet company standards for performance.
- Gained independent working skills and guided and mentored less experienced team members.
Crew Trainer
McDonald's
Turlock, CA
06.2018 - 02.2020
- Monitored daily operations in the kitchen to ensure smooth workflow and quality control.
- Ensured that all safety protocols were followed during training sessions.
- Monitored employee progress, offering constructive feedback for improvement.
- Assisted in creating a motivational atmosphere that encouraged team growth.
- Led by example, upholding company policies and exemplifying desired behaviors.
- Instructed new team members on correct procedures for operations.
- Explained goals and expectations required of trainees.
Crew Member
McDonald's
Turlock, CA
03.2017 - 05.2018
- Approached customers and engaged in conversation through use of effective interpersonal and people skills.
- Completed day-to-day duties accurately and efficiently.
- Operated equipment and machinery according to safety guidelines.
- Achieved cost-savings by developing functional solutions to problems.
- Worked effectively in team environments to make the workplace more productive.
Education
Bachelor of Arts - History
California State University, Stanislaus
Turlock, CA12-2021
Skills
- Workers' compensation
- Workers' compensation laws
- Claims documentation and organization
- Medical terminology
- Effective verbal and written communication
- Resourceful and analytical
- Adaptability and flexibility
- Multitasking
- Task prioritization
- Time management
Certification
- Licensed Claims Examiner in the State of Nevada
Timeline
Medical Only Claims Adjuster
Associated Risk Management, INC.
03.2025 - Current
Claims Assistant
Associated Risk Management, INC.
04.2023 - 03.2025
Index Clerk
Associated Risk Management, INC.
07.2022 - 03.2023
File Clerk
Associated Risk Management, INC.
03.2022 - 07.2022
Mail Clerk / Front Office Receptionist
Associated Risk Management, INC.
01.2022 - 03.2022
Crew Lead
McDonald's
03.2020 - 12.2021
Crew Trainer
McDonald's
06.2018 - 02.2020
Crew Member
McDonald's
03.2017 - 05.2018
Bachelor of Arts - History
California State University, Stanislaus
Education and Training
other