Hi, I’m
VERONICA LOZADA
Lakeland,FL
It is never too late to be what you might have been.
George Eliot
Summary
Enthusiastic Customer Services Professional with 15+ years of experience in organizational leadership, expertise in building and maintaining strong long-term relationships with customers. Well-versed in products, services, and consumer trends. Dependable achiever, committed to holding highest ethical standards and maintaining customer trust. Adept in finding creative and efficient ways to achieve optimal outcomes. Versed in building learning opportunities within everyday interactions and providing thorough and tactful feedback to foster professional development.
Overview
14
years of professional experience
1
Certificate
Work History
State FarmWinter Haven, FL
Licensed Auto Claims Adjuster
03.2017 - 07.2023
Job overview
- Accurately processed 100+ Medical Personal Injury Protection (PIP) and Medical Payments Coverage
(MPC) Claims from inception to completion.
- Obtained and analyzed medical bills, wage loss reviews, home services, mileage payments, and ensured compliance with fee schedules.
- Applied strong understanding and ability to conduct policy coverage analysis, including complex multijurisdictional issues.
- Acted as a liaison between policyholders and medical providers to ensure accurate processing for
medical treatment.
- Served as trainer for new and existing staff in the use of State Farm’s proprietary Enterprise Claims
System Program for the Deductible Dedicated Team.
Advent Health (Formerly Hearth of Florida)Davenport, FL
Patient Account Representative
07.2016 - 03.2017
Job overview
- Investigated and resolved issues with bills received from clients and providers.
- Maintained 100% compliance with organizational policies and regulations for patient privacy.
- Communicated with clients, vendors, providers, stakeholders, and other parties involved for any additional information required to process issues with claims or payments.
- Established effective debt repayment strategies based on customer’s financial situation, reducing delinquency debt rates by 15%.
- Successfully wrote appeal letters to insurance companies for denied claims, resulting in faster turnaround time.
Advent Health (Formerly Lake Wales Medical Center)Lake Wales, FL
Medical Bill Collector
03.2009 - 07.2016
Job overview
- Effectively used task work lists to submit prior authorization and pre-certification information to insurance companies.
- Provided prompt and accurate services by leveraging in-depth knowledge of government regulations, health benefits, and healthcare terminology, maintaining a 98% accuracy rate.
- Identified and resolved discrepancies regarding billing and reimbursements.
- Verified eligibility and benefits via online portals or other sources of automatic services.
- Streamlined claims processing procedures, resulting in a 20% increase in timely forwarding of claims
information to Medicare, Medicaid, Worker’s Compensation and Commercial insurance companies. - Successfully managed customer delinquencies by notifying account holders of delinquent accounts, creating
personalized repayment plans based on financial status, and successfully reconciling accounts through approved channels.
Education
Warner UniversityLake Wales, FL
Associate of Arts from Business Administration
Skills
- Leadership Experience
- Team Building, Training and Development
- HIPPA Compliant
- Insurance Regulations
- Florida 214 Life Agent License
- Florida 620 All Lines Adjuster License
- Creative Problem Resolution and Decision Making
- Versed in Negotiating Complex Liability Terms
- Abillity to Adapt in Stressful Situations
- Culturally Diverse
- Microsoft Office W/E/O/PP
- Fluent in English and Spanish
Languages
English
Full Professional
Spanish
Native/ Bilingual
Certification
- Florida 214 Life Agent License - 2019.
- Florida 620 Adjuster- All Lines - 2017.
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Licensed Auto Claims Adjuster
State Farm
03.2017 - 07.2023
Patient Account Representative
Advent Health (Formerly Hearth of Florida)
07.2016 - 03.2017
Medical Bill Collector
Advent Health (Formerly Lake Wales Medical Center)
03.2009 - 07.2016
Warner University
Associate of Arts from Business Administration
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