Melanie Clark
Spring
Summary
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Insurance Claims Representative
Abercrombie, Simmons & Gillette Claims Administration
10.2023 - Current
- Ensuring that compliance is met by processing and handling new incoming claims in a timely and efficient manner while maintaining accuracy and confidentiality
- Managing incoming calls in a professional manner from clients and provider’s alike by taking messages as needed and directing calls to the appropriate destination
- Responsible for creating and uploading invoices, documenting financial reports, and being first point of contact with the finance department regarding bill review services
- Maintaining record of all incoming and outgoing certified and traditional mail, including opening, date stamping, scanning, and uploading daily faxes to pertaining claim files while adhering to company timelines
Fulfillment Dept. Pacesetter/Guest Service Expert/Supervisor Assistant
Target
11.2017 - 10.2023
- Gathered and fulfilled online orders in a swift and timely manner to satisfy customer needs and meet store demands
- Oversaw and guided the fulfillment team to ensure that customer satisfaction is being properly met and executed while maintaining the proper pace to achieve our store goals/deadlines
- Monitored department data and tracked individual team member metrics to communicate dept
- Progress to the executive team lead
- Educated and prepared new team members with the necessary skills and knowledge to meet the expectations required for the fulfillment department
- Counted all cash received from previous day’s business to enter into computer database, balanced all cash in store safe, and distributed currency equally into registers before store open
- Addressed and achieved amicable solutions to all guest concerns related to product or store property
Unit Secretary/Patient Care Tech
St.Lukes Hospital
02.2022 - 07.2022
- Greeted patients and family members while providing excellent care prior to interacting with other medical professionals in our facility
- Administrative work such as updating and organizing patient files to ensure that all information is current for medical staff
- As well as answering phone calls, transferring patient files to Physicians and other floor units, scheduling procedures for patients, assigning rooms, and ordering office and medical supplies as needed
- Provided personalized care for patients by helping to carry out their daily living activities such as bathing, dressing, eating, and reporting their concerns to upper medical staff
- Performed medical tasks such as measuring and recording vital signs, blood draws, intakes/outputs, and blood sugar levels
Receptionist
Cypresswood Eye Care/TSO
02.2014 - 12.2016
- Managed appointment times by scheduling, rescheduling, or cancelling appointments
- Gathered, collected, and updated patient data to input into computer system for easy access
- Organized prescriptions and files for safe bookkeeping
- Ensured that patients and visitors were educated on the clinical procedures and policies
- Assisted in resolving any clients’ issues and/or complaints
- Handled any incoming or outgoing telephone calls
Education
Associates of Science -
Lone Star College
Tomball, TX05.2017
Skills
- Ability to work in a team and independently
- Adaptability
- Self-Motivated
- Supervision experience
- Customer Service experience
- General technical and machine skills
- Verbal and Written Communication
- Multi-tasking
- 90wpm Typing
- Claims investigation
- Policy interpretation
- Accident review
- Documentation research
Certification
- Certified Adjuster (CA) - Texas Department of Insurance.
Languages
Spanish
Native or Bilingual
Timeline
Insurance Claims Representative
Abercrombie, Simmons & Gillette Claims Administration
10.2023 - Current
Unit Secretary/Patient Care Tech
St.Lukes Hospital
02.2022 - 07.2022
Fulfillment Dept. Pacesetter/Guest Service Expert/Supervisor Assistant
Target
11.2017 - 10.2023
Receptionist
Cypresswood Eye Care/TSO
02.2014 - 12.2016
Associates of Science -
Lone Star College
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