MARK NELSON
Suwanee,GA
Summary
Detail-oriented Medical Claims Processor knowledgeable about automated systems and variations in plan benefits. Resolves high number of claims with fast and accurate analyses. Dependable in using proper classifications and meticulous recordkeeping. Knowledgeable Loan Processor bringing 3 years of experience in banking and financial positions. Highly skilled in working well with people of all backgrounds to complete loan packages. Adept at building loyalty and trust between bank and customer. Accuracy-focused banking professional experienced in transaction management and fraud prevention. Experienced in promoting products and services to drive revenue and customer loyalty. Persuasive communicator analytical in solving customers problems.
Overview
12
12
years of professional experience
Work History
Funding Specialist
Allied Benefit Systems Inc.
Atlanta, GA
01.2024 - Current
- Communicate with other Allied departments to resolve claim and funding issues.
- Appeal the denials or reduction of reimbursements by the stop loss carrier.
- Communicate funding information and requirements to clients appropriately.
- Assemble weekly or daily funding request information for clients.
- Handle releasing payments to providers or taking action on certain payments.
- Record bank transactions.
- Process claims payments for various vendor fees.
- Deposit checks received in the Funding Department.
CSR Claims Processor
WPSIC
Atlanta, GA
08.2022 - 01.2024
- CSR rep claims processing.
- Assist on all claims issues.
- provider certification assistance.
- explained denials and claims status.
- process CHCBP and schcp claims.
- Assisted on all appeals submissions.
- Problem solver in a high inbound call volume environment.
Loan Processor
Bond Street Mortgage
01.2020 - 08.2022
- Calculated income, assets and liabilities to meet lender requirements.
- Supported loan officiant and underwriter teams by ensuring timely, judicious and accurate loan processing.
- Reviewed and verified borrowers' income, credit reports and property appraisals to prepare documents for underwriting.
- Maintained fast-paced schedule by consistently providing satisfactory application approval turnaround times.
- Reviewed initial client documentation to structure and submit loan package.
Credit Operations Specialist
GreenSky Credit
Atlanta, GA
04.2017 - 01.2020
- Analyze and interpret credit reports, calculate and evaluate debt-to-income ratios.
- Complete these duties within established service level agreements (SLAs) to maintain acceptable turnaround times for submitted applications.
- Ensure compliance with established bank policies, company guidelines and regulatory requirements.
- Communicate, in a professional manner, via phone and email with customers to resolve pended applications and cases.
Claims Adjuster
Goldfein LLC
Atlanta, GA
03.2015 - 05.2017
- Obtained all necessary information to complete proper evaluation of injury claims
- Analyzed first reports of loss and underlying file material to determine if claim was suspect
- Adhered to company and insurance client's guidelines in claims processes, estimate writing and claim closures
- Contacted injured parties and legal representatives to negotiate final settlement for claims
- Reduced loss ratios through fair and prompt processing of claims
- Conducted claim and estimate re-inspections
- Kept up-to-date on changes in regulations for deductibles and collections
- Obtained relevant evidence and information regarding suspicious claims.
Customer Service Representative
Synovous
Alpharetta, GA
04.2013 - 03.2015
- Maintained confidentiality of bank records and client information, directed specific questions to appropriate branch personnel and exceeded customer service satisfaction ratings.
- Exceeded customer service satisfaction ratings by by providing prompt answers to specific questions.
- Offered every customer exceptional service levels by remaining friendly and professional during every transaction.
- Resolved problems or discrepancies concerning customers' accounts.
- Performed special services for customers, ordering bank cards and checks.
- Received mortgage and other loan payments, verifying payment dates and amounts due.
Education
Associates - Hospitality tourism
St Petersburg College
01.2014
High School Diploma -
W.H. Taft High School
06.1987
Skills
- Preparing applications Verifying information
- Mortgage Banking and Analysis Processing documents
- Proficient in Encompass
- Customer Service
- Data Entry
- Problem-Solving
- Vehicle Damage Assessment
- Decision Making
- Proficient in Microsoft Excel, Jira, and Salesforce
- Honest and Ethical
Timeline
Funding Specialist
Allied Benefit Systems Inc.
01.2024 - Current
CSR Claims Processor
WPSIC
08.2022 - 01.2024
Loan Processor
Bond Street Mortgage
01.2020 - 08.2022
Credit Operations Specialist
GreenSky Credit
04.2017 - 01.2020
Claims Adjuster
Goldfein LLC
03.2015 - 05.2017
Customer Service Representative
Synovous
04.2013 - 03.2015
Associates - Hospitality tourism
St Petersburg College
High School Diploma -
W.H. Taft High School
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