Hardworking and passionate job seeker with strong organizational skills eager to secure an entry-level position. Ready to help team achieve company goals.
Overview
6
6
years of professional experience
Work History
Claims Specialist
Medical Business Solutions
Perry, GA
10.2019 - 09.2020
Followed up with customers on unresolved issues.
Conducted full claim investigations and reported updates and legal actions.
Reviewed new files to determine current status of injury claim and to develop plan of action.
Escalated files with significant indemnity exposure to supervisor for further investigation.
Verified client information by analyzing existing evidence on file.
Checked documentation for accuracy and validity on updated systems.
Prepared insurance claim forms or related documents and reviewed for completeness.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
General Labor Worker
Perdue Farms
Perry, GA
01.2019 - 09.2019
Removed bones from chicken breast meat.
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
Carried out day-day-day duties accurately and efficiently.
Demonstrated respect, friendliness and willingness to help wherever needed.
Worked flexible hours; night, weekend, and holiday shifts.
Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
Crew Member
McDonald’s
Perry, Georgia
11.2017 - 04.2018
Ran the register while assisting customers in placing orders, as well as cross-selling and up- selling, improving store sales
Routinely commended in providing excellent customer service
Helped in providing routine maintenance around the store.
Provided excellent customer service by greeting customers and meeting quality expectations.
Took orders, prepared meals and collected payments.
Worked well with teammates and accepted coaching from management team.
Assisted other team members to achieve goals.
Accurately operated cash register to process customer payments.
Kept kitchen, counter and dining areas cleaned and sanitized.
Brewed coffee and tea and changed out drink station syrups.
Completed milkshakes and ice cream desserts for customers.
Readied customers' take-out orders in secure bags with appropriate amounts of condiments, silverware and napkins.
Documented customer orders and conveyed special requests to kitchen staff.
Replenished serving stations with fresh food and cleaned up spills.
Claims Specialist/Data Entry
Medical Business Solutions
Perry, Georgia
11.2013 - 08.2017
Verify details of transactions, including funds received and total account balances
Obtained information by contacting appropriate personnel or patients
Scanned incoming documentation
Followed-up with insurance companies and individuals to Resolve discrepancies
Kept department clean, organized and professional
Followed up with customers on unresolved issues.
Reviewed new files to determine current status of injury claim and to develop plan of action.
Reported policy changes and company conditions affecting customer satisfaction.
Escalated files with significant indemnity exposure to supervisor for further investigation.
Addressed average of 400 customer inquiries and complaints each week.
Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Generated, posted and attached information to claim files.
Maintained confidentiality of patient finances, records and health statuses.
Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
Checked documentation for accuracy and validity on updated systems.
Prepared insurance claim forms or related documents and reviewed for completeness.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Made contact with insurance carriers to discuss policies and individual patient benefits.
Reviewed 600 patient cases per week and verified insurance coverage information.
Education
Associates - Business Management
Central Georgia Technical College
Macon, GA
05.2023
College Diploma - EMS Professions
Central Ga Technical College
Warner Robins, GA
07.2020
College Diploma - Criminal Justice
Central Ga Technical College
Warner Robins, GA
05.2014
High School Diploma -
Peach County High School
Fort Valley, GA
05.2012
Skills
Settlement determinations
Coverage assessments
Claims
Documentation review
Excellent administrative abilities
Prior authorization processing
Reporting skills
Account management
Understanding of medical terms
Patient contact and Documentation abilities
Data integrity
Insurance industry experience
Timeline
Claims Specialist
Medical Business Solutions
10.2019 - 09.2020
General Labor Worker
Perdue Farms
01.2019 - 09.2019
Crew Member
McDonald’s
11.2017 - 04.2018
Claims Specialist/Data Entry
Medical Business Solutions
11.2013 - 08.2017
Associates - Business Management
Central Georgia Technical College
College Diploma - EMS Professions
Central Ga Technical College
College Diploma - Criminal Justice
Central Ga Technical College
High School Diploma -
Peach County High School
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