Summary
Overview
Work History
Education
Skills
Timeline
Generic

Nichole Vallentine

Herriman

Summary

OOS Claims Representative at Elevate PFS with a proven track record in claims resolution and compliance. Expert in insurance claims review and critical thinking, I enhanced processing strategies, reducing resolution times significantly. Adept at training teams and fostering professional growth, I bring strong attention to detail and effective time management skills.

Diligent Claims Representative with solid background in processing and managing claims efficiently. Adept at assessing coverage and liability, and resolving complex claims issues. Proven ability to utilize strong analytical and communication skills to deliver exceptional service.

Overview

18
18
years of professional experience

Work History

OOS Claims Representative

Elevate PFS
11.2016 - Current
  • Have experience with EV, Doc Proc, Pay Review, Follow Up, Appeals, and Claims Billing.
  • Processed and resolved claims while ensuring compliance with company policies and procedures.
  • Evaluated claims details to determine eligibility and appropriate billing options.
  • Assisted with training individuals as well as groups with more tricky payers such as Medi-Cal.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Reduced claim resolution times with thorough documentation and timely follow-up.
  • Analyzed claim trends to anticipate potential issues and proactively adjust processing strategies for California Medicaid.

Teller

Granite Credit Union
04.2007 - 11.2016
  • Mentored junior tellers, fostering professional growth and skill development.
  • Implemented process improvements, reducing transaction errors and enhancing customer experience.
  • Managed daily cash operations, ensuring compliance with security protocols and regulations.
  • Disbursed cash and checks accurately while maintaining security of cash drawers.
  • Promoted a welcoming atmosphere in the branch by greeting customers warmly upon arrival and addressing them by name when possible.
  • Answered telephone inquiries on checking and savings accounts, loans, and lines of credit.
  • Served as primary point of contact for customers, providing assistance with account maintenance and transactions.
  • Handled complex transactions such as wire transfers or foreign currency exchanges with accuracy and efficiency.

Education

Bingham High School
South Jordan
06-2006

Skills

  • Insurance claims review
  • Claims investigation
  • Time management
  • Decision-making
  • Attention to detail
  • Critical thinking
  • Data entry
  • Microsoft office
  • Microsoft Excel

Timeline

OOS Claims Representative

Elevate PFS
11.2016 - Current

Teller

Granite Credit Union
04.2007 - 11.2016

Bingham High School