Maira Rodriguez
Cicero,IL
Summary
Dynamic claims processor and experienced shift leader skilled in training and mentoring teams. Known for streamlining operations and resolving discrepancies, contributing to improved accuracy and efficiency in claims processing.
Overview
25
25
years of professional experience
Work History
Claims Processor
Mirra Healthcare
Spring Hill, FL
08.2025 - Current
- Processed insurance claims efficiently, ensuring compliance with company policies and regulations.
- Reviewed claim documentation for accuracy, identifying discrepancies and resolving issues promptly.
- Utilized claims management software to track and update claim statuses effectively.
- Communicated with healthcare providers to verify patient information and clarify claim details.
- Collaborated with internal teams to expedite claim resolutions and enhance customer satisfaction.
Shift Leader
Walgreens
Oak Park, IL
11.2003 - Current
- Supervised daily operations ensuring compliance with company policies and procedures.
- Trained and mentored team members to enhance customer service skills and product knowledge.
- Implemented inventory management practices that reduced stock discrepancies and improved accuracy.
- Resolved customer inquiries and complaints efficiently, enhancing overall satisfaction levels.
- Coordinated staff schedules to optimize productivity during peak business hours.
- Conducted regular performance evaluations to identify areas for improvement within the team.
- Monitored sales trends to inform restocking decisions and promotional strategies effectively.
- Trained new employees and delegated daily tasks and responsibilities.
- Maintained a clean and safe work environment while ensuring all employees adhered to safety guidelines and protocols.
- Resolved customer complaints and issues and offered thoughtful solutions to maintain customer satisfaction.
- Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
- Enforced company policies and regulations with employees.
- Managed shift operations, supplied resources and monitored team performance to keep business profitable and running smoothly.
- Provided ongoing training for new hires, fostering a positive team atmosphere that encouraged growth and development.
Claims Processor
Clearspring Healthcare
Park Ridge, IL
02.2022 - 08.2025
- Assisted in training new team members on claims processing procedures and software usage.
- Analyzed trends in claim submissions, providing insights for process improvement opportunities.
- Maintained organized records of processed claims, supporting audit readiness and regulatory compliance.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Assisted in Part C audits, Provider Disputes, Member Bills, reimbursement, tickets and Provider Refunds.
- Collaborated with varies departments to resolve any configuration, contract or eligibility issues that may delay the finalization of claims.
Bilingual Tele-recruiter
Adlab
Chicago, IL
06.2001 - 07.2003
- Conducted comprehensive candidate screenings to identify top talent for various roles.
- Utilized applicant tracking systems to manage candidate pipelines efficiently.
- Developed and maintained strong relationships with hiring managers to align recruitment strategies.
- Implemented targeted outreach initiatives to enhance candidate engagement and sourcing efforts.
- Managed a high volume of inbound calls efficiently and professionally while remaining focused on the primary goal of identifying qualified candidates.
- Performed inbound/outbound calls, scheduled/resheduled appointments for qualified candidates to ensure proper fit within client organizations.
Education
Bachelor of Science - Business Administration
North Park University
Chicago, IL05-2004
Skills
- Claims review
- Accuracy and precision
- Transactions reconciliation
- Claims
- Pharmacy Tech/Cpr/immunization certification
- Completed 2 year Leap Program (Lead, Engage, Advance and Perform)
Languages
Spanish
Native or Bilingual
Timeline
Claims Processor
Mirra Healthcare
08.2025 - Current
Claims Processor
Clearspring Healthcare
02.2022 - 08.2025
Shift Leader
Walgreens
11.2003 - Current
Bilingual Tele-recruiter
Adlab
06.2001 - 07.2003
Bachelor of Science - Business Administration
North Park University