Patti Flippo
Winter Haven,FL
Summary
- An experienced professional with more than 20 years’ experience in the insurance industry and 19 years of professional customer service environments, including management and training. Areas of expertise encompass the following:
- Customer Service
- Personnel/Management Development
- Extensive Work Experience
- Problem Resolution
Overview
15
15
years of professional experience
Work History
Sr Bodily Injury Claims Adjuster
GEICO
Lakeland, FL
04.2025 - Current
- Evaluated and processed bodily injury claims to ensure compliance with company policies and state regulations.
- Conducted thorough investigations, gathering evidence and documentation to support claim resolution decisions.
- Collaborated with medical professionals to assess injuries and determine appropriate compensation amounts.
- Negotiated settlements effectively, balancing customer satisfaction with company financial objectives.
Resolution Analyst/Sr Appeals Representative DSNP A&G Pre-Service
UnitedHealthcare Medicare and Retirement
01.2022 - 04.2025
- Research and resolve written complaints submitted by consumers and physicians/providers. Ensure complaint has been categorized correctly. Obtain additional documentation required for case review. Review case to determine if review by clinician is required. Render decision for non-clinical complaints using sound, fact-based decision making. Complete necessary documentation of final appeals or grievance determination using appropriate templates. Communicate appeal or grievance information to members or providers and internal/external parties within the required timeframes.
Sr Grievance Coordinator
UnitedHealthcare Medicare and Retirement
01.2017 - 01.2022
- Research and resolve written Executive grievances submitted by consumers and forwarded by the Legal Risk Management (LRM) department, as well as quality of care and quality of service grievances. Ensure quality of care and quality of service grievance has been categorized correctly, obtain additional documentation required for case review, review case to determine if review by clinician is required, render decision for non-clinical complaints using sound, fact-based decision making, and complete necessary documentation of final grievance determination using appropriate templates. Communicate appeal or grievance information to members and internal/external parties within the required timeframes.
Sr Platinum Provider Resolution Specialist
UnitedHealthcare Medicare and Retirement
08.2015 - 01.2017
- Develops a strong and trusted relationship with the caller by providing personal contact information ie: dedicated fax number and/or email address Conduct outbound follow up calls to take ownership of the research and resolution of the service issue. Deliver all information and questions in a positive, conversational and compassionate manner while embracing the gray. Develops a strong and knowledgeable relationship with the provider, while providing the best customer service experience and ensuring first call resolution. Review and educate providers on Appeals/Grievance process and discuss outcomes and expectations related to appeal submissions. Manage requests for services from providers processing prior authorization intake requests and referrals. Assigned as team SME to resolve escalation and Supervisor requests completing follow up.
Sr Provider Resolution Specialist-Telecommuter
UnitedHealthcare Medicare and Retirement
07.2011 - 08.2015
- Respond to complex provider calls. Resolve customer service inquiries which could include appeals and grievance reviews, benefit and eligibility information, billing and payment issues, provider material requests, physician assignments, authorization review for treatment, and Explanation of Benefits (EOB). Provide excellent customer service; constantly meet established productivity, schedule adherence, and quality standards.
Education
Associates of Applied Science - Business Administration
Tampa College
FloridaSkills
Motivated and adaptable professional with a strong focus on delivering results Supported teams in achieving high-quality outcomes through initiative and dedication Collaborated effectively with colleagues, demonstrating strong communication and time management skills Familiar with various applications including Excel, SharePoint, and Citrix/iset
Timeline
Sr Bodily Injury Claims Adjuster
GEICO
04.2025 - Current
Resolution Analyst/Sr Appeals Representative DSNP A&G Pre-Service
UnitedHealthcare Medicare and Retirement
01.2022 - 04.2025
Sr Grievance Coordinator
UnitedHealthcare Medicare and Retirement
01.2017 - 01.2022
Sr Platinum Provider Resolution Specialist
UnitedHealthcare Medicare and Retirement
08.2015 - 01.2017
Sr Provider Resolution Specialist-Telecommuter
UnitedHealthcare Medicare and Retirement
07.2011 - 08.2015
Associates of Applied Science - Business Administration
Tampa College