Mary Hardnett
Prairieville,LA
Summary
Tactful Claims Specialist with expertise in settlement preparation, claims processing and appeal filing. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating complex liability claims. Committed to maintaining customer satisfaction and contributing to company success.
Overview
11
11
years of professional experience
Work History
Freight Broker
Export Brokerage Llc
08.2021 - Current
- Monitored market and negotiated rates based on trends.
- Tracked shipments and trucks out on deliveries.
- Planned routes for various shipments according to special events, customer needs and weather.
- Contacted existing customers to update accounts and confirm deals.
- Verified and noted count and condition of cargo received.
- Stayed updated on latest knowledge in transportation and logistics to provide relevant solutions to clients.
- Communicated with drivers and dispatch to coordinate delivery schedules.
- Operated computer systems to track shipments to improve efficiency and accuracy.
- Collaborated with team members to resolve challenges and improve productivity.
- Maintained clean and organized work area to improve efficiency and comply with regulations.
- Observed and tracked consignments to verify timely deliveries and accurate invoicing.
Claims Specialist
United Healthcare
07.2018 - 08.2021
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Claims Representative
Blue Cross Blue Shield Of Louisiana
04.2013 - 07.2018
- Analyzed and addressed escalated claims to resolve issues quickly.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Updated claims system to track claim status and provide relevant information to other department.
- Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
- Maintained accurate and up-to-date records of claim information for future reference.
- Followed up with customers on unresolved issues.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Generated, posted and attached information to claim files.
- Developed and implemented strategies to improve claim processes.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
- Communicated effectively with staff members of operations, finance and clinical departments.
Education
GED -
Eastland Farfield Career Center
Groveport, OH02.2004
Skills
- Cold-Calling
- Transportation Management Systems
- [Software] Expert
- Price Quoting
- Account Management
- Route Planning
- Rate Negotiation
- Data Entry
- Third-Party Logistics
- Customer Engagement
- Shipment Tracking
- SAP Warehouse Systems
- Coverage Assessments
- Compliance Management
- Settlement Determinations
- Documentation Review
- Claims
- Data Analysis
- Decision-Making
- Claims Investigation
- Database Management
- Time Management
- Insurance Claims Review
- Policy Understanding
- Conflict Resolution
- Call Center Operations
- Escalation Management
- Payment Processing
- Customer Support
- Eligibility Determination
- Call Center Customer Service
- Cloud Applications
- Keyboarding
- Written and Oral Communication
- Customer Service
- Technical Support
- Windows 10
- Ticket Support System Management
- LAN/WAN
- Mac Systems
- Technical Issues Analysis
- Microsoft Outlook
- Microsoft Office Specialist (MOS) Expert
- SAP Software
- Quality Assurance
- Complaint Resolution
- Customer Retention
- MS Office
- Budgeting and Reporting
- Customer Relationship Management Software (CRM)
- Quality Assurance Controls
- Product Knowledge
- Adherence to High Customer Service Standards
- Administrative Support
- Information Security
- One Call Resolution
- Service Delivery Optimization
Timeline
Freight Broker
Export Brokerage Llc
08.2021 - Current
Claims Specialist
United Healthcare
07.2018 - 08.2021
Claims Representative
Blue Cross Blue Shield Of Louisiana
04.2013 - 07.2018
GED -
Eastland Farfield Career Center