Summary
Overview
Work History
Education
Skills
Timeline
Generic

Monica Gilbuena

Reedley

Summary

Administrative support specialist with 7 years of experience providing support in a professional business setting. Knowledgeable in processing Worker's Compensation insurance claims while adhering to policy terms and conditions. Facilitates claims processing by cultivating productive relationships with stakeholders. Blends analytical and administrative acumen throughout investigations and recommendations with claims processing. A proven track record of using my excellent personal, communication and organization skills and improve department efficiencies. Team player with excellent communication skills, high quality of work, driven and highly self-motivated.

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

7
7
years of professional experience

Work History

Claims Assistant

TRISTAR
Sacramento
10.2022 - 07.2025

  • Entered indemnity benefits into claims system accurately and in a timely manner.
  • Sent out benefit notices to ensure compliance with regulatory requirements.
  • Submitted subpoenas and IMR (Independent Medical Review) requests as needed.
  • Gathered and organized work status information on injured workers to support claim processing.
  • Processed and paid bills related to claims.

Claims Associate

Pacific Claims Management
Fresno
04.2018 - 06.2022
  • Provided clerical support in a professional setting while answering and routing calls throughout the office.
  • Carried out administrative tasks such as communicating with clients, distributing mail, and scanning documents.
  • Assured timely verification of Patient's insurance benefits prior to procedures and appointments.
  • Processed large volumes of workmen's compensation claims in a fast-moving work environment.
  • Maintained communication and followed up with claims adjusters and examiners to expedite processing of claims.
  • Examined reports, accounts, and documentation to determine integrity and accuracy of information.
  • Communicated with customers on unresolved issues to ensure timely filing of claims.
  • Verified client information by analyzing existing evidence on file and confirming information.
  • Posted payments to accounts and maintained records for filing.
  • Generated documents, posted and attached information to claim files for appropriate processing.

Education

Culinary Arts Specialist - Culinary Arts

Institute of Technology
Clovis, CA
09.2005

High School Diploma -

Reedley, CA
06.2004

Skills

  • Spanish
  • Administrative abilities
  • Secretarial support
  • Claims Processing
  • Patient follow-up
  • Claims follow-up
  • Data Integrity
  • Communication
  • Documentation review

Timeline

Claims Assistant

TRISTAR
10.2022 - 07.2025

Claims Associate

Pacific Claims Management
04.2018 - 06.2022

Culinary Arts Specialist - Culinary Arts

Institute of Technology

High School Diploma -