Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michelle Timm

Green Bay,WI

Summary

Accomplished Claims Auditor with a proven track record at United Healthcare, adept in claims auditing and demonstrating exceptional attention to detail. Skilled in utilizing Facets and Mainframe, with a knack for improving customer satisfaction and initiating cost containment measures. Excelled in teamwork and problem-solving, significantly enhancing operational efficiency and compliance.

Overview

30
30
years of professional experience

Work History

Claims Auditor

United Healthcare
09.2020 - Current
  • Identified fraudulent activities by conducting detailed audits on suspicious claims, protecting company resources.
  • Participated in ongoing professional development opportunities to stay current on industry trends, enhancing personal skill set and benefitting the organization.
  • Improved customer satisfaction by providing timely and accurate feedback on submitted claims, facilitating a positive experience.
  • Initiated cost containment by conducting thorough audits and data mining.

Claims Adjuster

United Healthcare
03.2010 - 09.2020
  • Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
  • Examined claims forms and other records to determine insurance coverage.
  • Documented all investigation activity and presented reports to management.
  • Verified insurance claims and determined fair amount for settlement.

Underwriting Assistant

United Healthcare
01.1995 - 03.2010
  • Assisted in the negotiation of policy terms and conditions, demonstrating strong analytical skills and attention to detail.
  • Reviewed applications for insurance coverage and reports from loss control specialists to determine risks.
  • Ensured compliance with all regulatory requirements through diligent record-keeping and strict adherence to company policies.
  • Reviewed policy documents for completeness and accuracy before submission, minimizing the need for revisions or cancellations due to errors.

Education

High School Diploma -

Green Bay East High School
Green Bay, WI
06.1988

Skills

    Claims Auditing

    Claims Processing

    Documentation Review

    Experienced in use of Facets and Mainframe

    Some use with Microsoft excel and word

    Teamwork and Collaboration

    Attention to Detail

    Problem-solving abilities

    Adaptability and Flexibility

    Workload prioritization

Timeline

Claims Auditor

United Healthcare
09.2020 - Current

Claims Adjuster

United Healthcare
03.2010 - 09.2020

Underwriting Assistant

United Healthcare
01.1995 - 03.2010

High School Diploma -

Green Bay East High School

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Michelle Timm