Detail-oriented claims analyst with extensive experience in determining complex claim outcomes across various programs. Known for strong adaptability and effective communication, consistently delivering accurate assessments while ensuring regulatory compliance.
Overview
12
12
years of professional experience
Work History
Disability Determination Services
State of Kansas
Topeka, KS
03.2021 - Current
Self-motivated, with a strong sense of personal responsibility.
Work effectively in fast-paced environments while being well organized and multitasking to ensure timely and accurate completion.
Skilled at working independently and collaboratively in a team environment.
Proven ability to learn quickly and adapt to new situations.
Determine claim outcomes on multiple case types, both Title 2 and Title 16 programs.
Prepare assessments of physical and psychological function capacity with compelling rational for conclusions leaving little room for interpretation.
Collect and analyze medical and other records, collaborate with consultants to review and assess all documents submitted.
Written communication with claimants in regard to notices affecting claimants rights and benefits. Respond to inquiries requesting status or clarification.
Full time 40 hour weeks.
Inbound Warehouse Associate
Home Depot
5200 SW Wanger St
07.2018 - 03.2021
Received and processed incoming inventory, ensuring accurate stock levels and organization.
Licensed to operated forklifts and pallet jacks to transport materials efficiently within warehouse environment.
Implemented safety protocols, reducing workplace incidents through consistent training and awareness initiatives.
Coordinated with team members to streamline order fulfillment processes, enhancing overall productivity.
Trained new associates on warehouse procedures, fostering a culture of teamwork and adherence to standards.
Streamlined inbound processes by accurately receiving, sorting, and storing incoming shipments.
Full time 40 hours a week.
Customer Service Representative
Blue Cross Blue Shield Of Kansas
1133 SW Topeka Blvd
07.2014 - 2018
Medical terminology.
Provided timely support to customers through phone and email communications.
Resolved inquiries regarding health insurance policies and claims processing.
Assisted in maintaining accurate customer records using internal databases.
Collaborated with team members to streamline service delivery processes.
Educated clients on benefits, coverage options, and enrollment procedures.
Ensured compliance with regulatory standards in customer interactions.
Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
Kansas Insurance License.
Full time 40 hours a week.
Education
No Degree - Medical Termonology
Healthy Blue
Topeka, KS
07-2014
High School Diploma -
Holton High School
Holton, KS
05-2004
Skills
Friendly, positive attitude
Teamwork and collaboration
Customer service
Develop, review, examine, investigate and adjudicate claims timely and authoritatively
Determine complex claim outcomes-including initial, childhood, reconsideration, and medical continuing disability reviews
Organize and prioritize multiple tasks in a fast pass environment
Obtain and analyze medical and other evidence while maintaining time efficiency
Policy and regulatory compliant
Medical understanding of findings, causes, and treatment methods in relation to physical and mental impairments
Ability to complete vocational analysis
Accomplishments
Collaborate with supervision to train local field offices with what paperwork is required to finalize determinations on multiple case types.
Operations Assistant - Disability Support Services at East Carolina UniversityOperations Assistant - Disability Support Services at East Carolina University