RUNDA ELMASRI
Carnegie,PA
Summary
Experienced in managing insurance claims and resolving complex cases with a track record of excellence in customer service and teamwork. Skilled in handling customer, client, and provider insurance claims, successfully managing high caseloads in fast-paced environments. Organized, driven, and adaptable with excellent planning and problem-solving abilities. Offering 20 years of experience and a willingness to take on any challenge. Results-oriented achiever with a proven ability to exceed targets and drive success by combining strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
8
8
years of professional experience
Work History
Claim Specialist
United Healthcare
10.2022 - 05.2025
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts | Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information | Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.
Administrator
Family Choice Healthcare
03.2021 - 10.2022
- Increased customer satisfaction through professional handling of inquiries and prompt resolution of issues | Demonstrated exceptional multitasking abilities while juggling diverse responsibilities | Optimized budget management by monitoring expenses, negotiating supplier contracts, and identifying cost-saving opportunities | Maintained electronic filing systems for easy retrieval of information.
Senior Claims Manager
Cigna
02.2017 - 03.2021
- Collaborated with cross-functional teams to achieve project goals on time and within budget | Maintained database systems to track and analyze operational data | Evaluated staff performance and provided coaching to address inefficiencies | Provided reporting for forecast analysis as well as monitoring and inspecting production.
Education
MBA - Business Administration And Management
University of Phoenix
Tempe, AZ09-2026
Bachelor of Science - Industrial And Organizational Psychology
University of Phoenix
Tempe, AZAssociate of Science - Health Management and Clinical Assistance
University of Phoenix
Tempe, AZSkills
- Claims investigation and Legal compliance Policy interpretation and Risk assessment Claims analysis, Claims processing and adjustment Records management and Quality control Conflict resolution and Regulatory compliance adherence Computer proficiency, Data entry software Adaptability and flexibility Multitasking Abilities Critical thinking
Timeline
Claim Specialist
United Healthcare
10.2022 - 05.2025
Administrator
Family Choice Healthcare
03.2021 - 10.2022
Senior Claims Manager
Cigna
02.2017 - 03.2021
MBA - Business Administration And Management
University of Phoenix
Bachelor of Science - Industrial And Organizational Psychology
University of Phoenix
Associate of Science - Health Management and Clinical Assistance
University of Phoenix
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