Dynamic Claims Examiner with Sedgwick Claims Management Services, adept at reducing processing times and negotiating favorable settlements. Skilled in claims investigation and customer service, I foster strong client relationships while ensuring confidentiality. Committed to continuous professional development, I leverage effective communication and data verification to achieve high-quality outcomes.
Overview
16
16
years of professional experience
Work History
Claims Examiner
Sedgwick Claims Management Services Inc.
12.2012 - Current
Provided exceptional customer service by empathetically addressing claimants'' concerns and effectively explaining the claims process to them.
Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
Maintained current knowledge of industry developments, regulations, and best practices through continuous professional development activities.
Negotiated settlements with claimants'' attorneys when needed, achieving favorable outcomes for both parties while minimizing costs.
Managed caseloads effectively while maintaining high-quality work standards and meeting strict deadlines consistently.
Established strong working relationships with clients through excellent communication skills, fostering long-term partnerships.
Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
Medical Biller
Prime Care Physicians
06.2009 - 11.2012
Verified insurance of patients to determine eligibility.
Communicated with insurance providers to resolve outstanding sates of service.
Ensured timely payments from insurance providers through submission of accurate and complete claims.
Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.