Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Rosa Negrete

Summary

Lost time claims adjuster.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Workers Compensation- Claim Representative I

CCMSI
11.2023 - Current
  • IL & WI lost time claims
  • Prioritized workload effectively under pressure, consistently meeting deadlines without sacrificing quality or accuracy in claim processing tasks.
  • Conducted regular audits on processed claims to maintain quality control standards within the department.

Workers Compensation – Claim Associate II Level UP

CCMSI
06.2022 - 11.2023
  • Completed Level up program
  • Handled medical and incident claims.


Workers Compensation-TPA & Federal Team Lead

Athletico
05.2019 - 06.2022
  • Manage One Call's and Medrisk aged account receivable reports.
  • Manage Department of Labor aged accounts.

Workers Compensation -One Call Team AR Lead

Athletico
09.2018 - 04.2019
  • Manage One Call's aged account receivable reports.
  • Created weekly, monthly, and quarterly expense reports.

Worker Compensation AR representative

Athletico
11.2017 - 08.2018
  • Manage One Call's aged account receivable reports.

Administrative Assistant

Saint Anne & Saint Ambrose
04.2017 - 08.2017
  • Establish calendar of meetings and events; manage new and existing parishioners in database
  • Order supplies for both parishes and offices; collaborate to create weekly parish bulletins.

Insurance Verification/Receptionist

Osafo Health Care
01.2016 - 04.2017
  • Verified insurance benefits for commercial, Medicaid & Medicare; completed explanation of benefits
  • Posted payments to patients accounts from healthcare insurances and patients
  • Coordinated referrals and insurance verifications
  • Billed workman's comp and 3rd party insurance claims; processed admission and discharged documents
  • Maintained a high-volume of daily calls, fax and emails.

Education

Master of Science - Health Policy

Elmhurst College
Elmhurst, IL
01.2025

Bachelor of Science - Healthcare Management

DeVry University
Addison, IL
01.2018

Skills

  • Microsoft Office, Word, Excel, Publisher
  • Problem Resolution
  • Organizing and Prioritizing Work
  • Decision-Making
  • Claims Investigation
  • Claims adjustment
  • Lost time claim handling

Certification

Texas Adjuster License

Timeline

Workers Compensation- Claim Representative I

CCMSI
11.2023 - Current

Workers Compensation – Claim Associate II Level UP

CCMSI
06.2022 - 11.2023

Workers Compensation-TPA & Federal Team Lead

Athletico
05.2019 - 06.2022

Workers Compensation -One Call Team AR Lead

Athletico
09.2018 - 04.2019

Worker Compensation AR representative

Athletico
11.2017 - 08.2018

Administrative Assistant

Saint Anne & Saint Ambrose
04.2017 - 08.2017

Insurance Verification/Receptionist

Osafo Health Care
01.2016 - 04.2017

Master of Science - Health Policy

Elmhurst College

Bachelor of Science - Healthcare Management

DeVry University

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Rosa Negrete