Summary
Dedicated team player adept at managing customer service and claims processing for policyholders. Looking for a long-term position with a growth-oriented company. Highly-motivated employee with desire to take on new challenges. Strong worth 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
Insurance Claims Representative
Lynxservices
Westlake, TX
01.2020 - Current
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Verified details with policyholders and requested additional information.
- Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
- Served as subject matter expert for non-standard coverage questions, property damage and collision.
Picker Packer
Scentsy
Coppell, TX
01.2019 - 01.2020
- Fulfilled orders quickly to accomplish challenging daily objectives.
- Selected products and items from shelves and pallets for customer orders.
- Picked products from designated locations using various tools and transferred to appropriate areas for further processing.
- Worked additional hours and shifts to meet tight deadlines during peak periods.
- Promoted workplace safety and smooth production by keeping workspaces clean, organized and free of hazards.
Prior Authorization Specialist
CVS Aetna
Richardson, TX
11.2017 - 12.2018
- Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
CNA
Carrollton Nursing And Rehab
Carrollton, TX
07.2016 - 10.2017
- Answered signal lights, bells or intercom systems to determine resident needs.
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
- Assisted patients with shaving, bathing and oral hygiene to promote healthy habits and overall wellness.
- Observed and reported unusual symptoms and changes to charge nurse.
CNA
IRVING NURSING & REHABILITATION
IRVING, TX
11.2015 - 07.2016
- Conducted routine checks on patient vitals, blood pressure, blood sugar and heart rate.
- Assisted residents with bathing and dressing to promote personal hygiene.
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers.
- Used mobility devices to transport patients.
Education
HIGH SCHOOL DIPLOMA - SIMSBORO HIGH
05.2011
- Honor Roll
- Top Ranked: 25%
- Member of Honor Society
Some College (No Degree) -
Skills
- Excellent communication
- Spelling, and grammar skills
- Ability to follow oral and written instructions
- Ability to work independent professional timely manner
- Insurance terminology
- Documentation skills
- Policy knowledge
- Documentation research
- Coverage determination
Timeline
Insurance Claims Representative - Lynxservices
01.2020 - Current
Picker Packer - Scentsy
01.2019 - 01.2020
Prior Authorization Specialist - CVS Aetna
11.2017 - 12.2018
CNA - Carrollton Nursing And Rehab
07.2016 - 10.2017
CNA - IRVING NURSING & REHABILITATION
11.2015 - 07.2016
Simsboro High School - HIGH SCHOOL DIPLOMA, SIMSBORO HIGH
College of Southern Nevada - Some College (No Degree),
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