MELISSA BARBER
Star,Idaho
Summary
Dynamic insurance professional with strong analytical skills and a proven track record at Progressive Auto Insurance. Expert in thorough claims reviews and effective communication, enhancing customer satisfaction and resolving complex issues. Recognized for critical decision-making and teamwork, consistently achieving optimal outcomes in high-pressure environments.
Overview
13
13
years of professional experience
Work History
CURBI Adjuster
Progressive Auto Insurance
01.2025 - Current
- Investigated and determined insurance policy coverage.
- Conducted thorough investigations, gathering evidence such as medical records, police reports, and witness statements to determine liability accurately.
- Enhanced customer satisfaction by providing timely updates on claim status.
- Maintained contact with claimants to determine treatment status.
- Reviewed insurance bills and records to determine a fair amount for settlement.
- Evaluated, negotiated and settled unrepresented bodily injury claims.
PIP Floater
Progressive Auto Insurance
02.2024 - 01.2025
- Provided coverage for KS, UT, and ND PIP reps while on PTO.
- Worked with floater team to manage action items and bills.
- Checked voicemails, returned calls, and worked new diaries for all reps who were out 3 or more days.
- Provided feedback to leaders when trends were observed and additional training was needed.
- Managed No Home buckets.
Medical Claims Adjuster
Progressive Auto Insurance
11.2021 - 01.2025
- Handled KS PIP claims
- Researched policy contracts, regulations, and cause of injury to make accurate coverage decisions.
- Managed high volume caseloads, prioritizing urgent and sensitive cases for immediate attention.
- Reviewed and analyzed medical records to assess correlation between injuries and motor vehicle accidents, while identifying any prior conditions or injuries that could impact treatment outcomes.
- Provided exceptional customer service by actively listening, explaining claims process, setting clear expectations, and anticipating customer needs.
- Helped mentor new peers and provided ongoing support to help ensure successful integration into the team.
- Tested updates to Bill Triage screen for process.
- Covered the late schedule for the entire PIP department.
Office Billing Manager
NorthStar Physical Therapy
02.2020 - 11.2021
- Collected and entered all patient demographic and billing information.
- Verified medical benefits and authorization requirements for services.
- Submitted medical claims after reviewing for accurate coding.
- Reviewed billing problems, researched issues, and resolved concerns.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Managed the accounts receivable process, ensuring prompt payments from clients and minimizing outstanding balances.
Insurance Billing Specialist
St. Luke's Health System
08.2012 - 12.2016
- Minimized errors in claims submissions through regular cross-checking of CPT and ICD codes against medical documentation.
- Optimized revenue recovery efforts by efficiently identifying underpayments and resolving discrepancies with payers.
- Reduced processing time with thorough pre-authorization requests, ensuring prompt approvals for patient procedures.
- Provided exceptional customer service to patients when discussing billing matters, demonstrating empathy and professionalism at all times.
Education
Health Care Management
Brown Mackie College
Boise, IdahoSkills
- Strong analytical skills
- Critical Decision-Making
- Adaptability and flexibility
- Workload prioritization
- Complex Problem-solving
- MDP Proficiency
- MES for Peer Review and IME’s
- Effective Communication
- Settlement negotiations
- Team collaboration
Timeline
CURBI Adjuster
Progressive Auto Insurance
01.2025 - Current
PIP Floater
Progressive Auto Insurance
02.2024 - 01.2025
Medical Claims Adjuster
Progressive Auto Insurance
11.2021 - 01.2025
Office Billing Manager
NorthStar Physical Therapy
02.2020 - 11.2021
Insurance Billing Specialist
St. Luke's Health System
08.2012 - 12.2016
Health Care Management
Brown Mackie College