A highly motivated and experienced Claims Specialist with a proven track record in the insurance industry. Skilled in claims processing and data analysis.
A dedicated public health professional with expertise in food safety regulation .
Overview
19
19
years of professional experience
Work History
Quality Control Analyst
Caviness Beef Packers
09.2023 - Current
Reported problems and concerns to management.
Provided training to new hires on quality control procedures, fostering a culture of excellence within the team.
Recorded and organized test data for report generation and analysis.
Monitored testing procedures and verified performance of tests according to established item specifications and protocol.
Supported continuous improvement initiatives by analyzing data trends and recommending process enhancements.
Federal Inspector
USDA-FSIS
06.2014 - 07.2023
Examined products for imperfections and defects.
Prepared reports detailing findings of inspections, investigations, and tests.
Recorded inspection and test results on data sheets.
Followed standard operating procedures for inspections and tests.
Identified potential hazards and recommended corrective actions, ensuring a safer work environment for all employees.
Upheld codes and regulations governing materials, processes, and procedures.
Trained other workers in inspection and testing procedures.
Dental and Medical Analyst
Insurance Management Services
02.2006 - 07.2014
Review and verify dental claims submitted by dentist to ensure accuracy, eligibility and proper coding.
Processed and tracked requests for dental medical records from external organizations.
Benefit verification
Claim denial management
Claim adjudication
Claim denial management
Communication with denial offices
Education
Associate of Science -
Amarillo College
Amarillo
Skills
Critical thinking
Teamwork
Time management
Attention to detail
Adaptability
Customer service
Communication
Languages
Spanish
Native or Bilingual
Timeline
Quality Control Analyst
Caviness Beef Packers
09.2023 - Current
Federal Inspector
USDA-FSIS
06.2014 - 07.2023
Dental and Medical Analyst
Insurance Management Services
02.2006 - 07.2014
Associate of Science -
Amarillo College
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