September Sledge
Detroit,MI
Summary
I am looking for a work-at-home position as a Disability Specialist with the advancement of opportunities into a management position as my career. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management, and problem-solving skills.
Overview
9
9
years of professional experience
Work History
Team Leader
Metlife
07.1998 - 09.2007
- Supervised team members to confirm compliance with set procedures and quality requirements.
- Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
- Built strong relationships with customers through positive attitude and attentive response.
- Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
- Worked with team to identify areas of improvement and devised solutions based on findings.
- Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
- Conducted training and mentored team members to promote productivity, accuracy, and commitment to friendly service.
- Managed conflict resolution among team members, fostering a positive and collaborative work environment.
- Maintained an inclusive and diverse team culture, promoting respect and understanding among all members.
- Promoted high standards through personal example to help each member understand expected behaviors and standards.
Disability Claims Specialist
Sedgwick CMS
05.2007 - 06.2007
- Collaborated with healthcare providers to obtain crucial information, leading to more accurate and faster decision-making on claims.
- Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
- Reduced claim processing time by conducting thorough assessments and providing accurate documentation for each case.
- Identified fraudulent claims by conducting detailed investigations and applying expert knowledge of disability guidelines and regulations.
- Supported the development of new claims management software, providing valuable input based on experience and expertise in disability claims handling.
- Played a critical role in resolving customer complaints by addressing concerns and providing clear explanations about claim decisions, maintaining positive relationships with clients.
- Increased client retention rates by building strong relationships through regular follow-ups and updates on claim status.
- Conducted comprehensive evaluations to determine eligibility for benefits, ensuring compliance with company policies and government regulations.
- Demonstrated attention to detail when reviewing medical records, enabling accurate assessment of functional limitations caused by disabilities.
- Streamlined communication between departments by establishing clear protocols, leading to enhanced collaboration in resolving claims issues.
- Enhanced customer satisfaction with timely communication and empathetic support during the claims process.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Generated, posted and attached information to claim files.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Posted payments to accounts and maintained records.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained confidentiality of patient finances, records, and health statuses.
- Coordinated with contracting department to resolve payer issues.
- Communicated verification and authorization status updates with [Type] department to facilitate decision-making for patient admissions and insurance coverage.
- Determined appropriateness of payers to protect organization and minimize risk.
Disability Specialist
Metlife
10.2005 - 12.2005
- Developed individualized plans to facilitate successful reintegration into the workforce for disabled individuals.
- Effectively communicated complex information about disability benefits programs to a diverse clientele, ensuring that all individuals had a clear understanding of their entitlements and available resources.
- Assisted clients in understanding their rights and responsibilities under the Social Security Disability program.
- Remained up-to-date on industry trends and advancements in disability support services, leveraging this knowledge to better serve claimants and their families.
- Evaluated disability claims for eligibility, ensuring accurate and timely processing of applications.
- Maintained comprehensive knowledge of federal regulations and policies governing disability benefits programs, ensuring compliance at all times.
- Educated clients about available resources and support services, empowering them to make informed decisions about their healthcare options.
- Collaborated with medical professionals to gather pertinent information for accurate decision-making on disability claims.
Education
Bachelor of Science - Human Resources Management
University of Arizona Global Campus
Chandler, AZ09.2027
High School Diploma -
Cooley High School
Detroit, Michigan06.1988
Skills
- Teamwork and Collaboration
- Problem-Solving
- Attention to Detail
- Team motivation
- Team Supervision
- Staff Training
- People Management
- Work Planning and Prioritization
Timeline
Disability Claims Specialist
Sedgwick CMS
05.2007 - 06.2007
Disability Specialist
Metlife
10.2005 - 12.2005
Team Leader
Metlife
07.1998 - 09.2007
Bachelor of Science - Human Resources Management
University of Arizona Global Campus
High School Diploma -
Cooley High School
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