Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ramona Hurtado

San Antonio,TX

Summary

Enthusiastic examines claims, negotiates and processes settlements and verifies insurance coverage. Attentive team player consistently treats clients fairly and equitably. Motivated to succeed in fast-paced and deadline-driven professional environment.

Overview

11
11
years of professional experience

Work History

Claim Specialist

United Healthcare
03.2022 - Current
  • Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
  • Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
  • Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
  • Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.

Claims Specialist

USAA Federal Savings Bank
08.2016 - 04.2021
  • Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
  • Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
  • Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
  • Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.

Crisis Helpline

Medtronic
06.2014 - 03.2016
  • Provided timely assistance to individuals in crisis, utilizing active listening skills and empathy to establish rapport quickly.
  • Conversed with individuals in crisis which called or texted hotline for assistance.
  • Managed high-stress situations with a calm demeanor, providing the necessary support to both clients and team members during challenging times.
  • Evaluated risk to client or others by gathering information and conducting assessments.

Education

Diploma -

Thomas Jefferson HighSchool
San Antonio, TX

Skills

  • Policy Interpretation
  • Legal Compliance
  • Financial Acumen
  • Claims Investigation

Timeline

Claim Specialist

United Healthcare
03.2022 - Current

Claims Specialist

USAA Federal Savings Bank
08.2016 - 04.2021

Crisis Helpline

Medtronic
06.2014 - 03.2016

Diploma -

Thomas Jefferson HighSchool

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Ramona Hurtado