Veronica Rivera
Tampa,Florida
Summary
Dedicated and detail-oriented individual seeking a claims adjuster position to utilize strong analytical and communication skills in accurately assessing and processing claims for optimal client satisfaction and organizational success. Ability to handle multiple projects simultaneously with a high degree of accuracy. Willingness to take on added responsibilities to meet team goals.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Treatment/Insurance Coordinator
Tampa Bay Institute Of Oral Surgery
05.2021 - Current
- Assisted clients with navigating complex insurance policies, ensuring they understood the extent of their coverage and benefits available to them during the claims process.
- Established an effective system for tracking and monitoring claims from initial report to final resolution, ensuring timely updates were provided to all relevant parties.
- Mitigated potential litigation risks through careful attention to detail in documenting evidence gathered during investigations and Pre Authorization/claim evaluations.
- Successfully negotiated settlements with claimants and insurers.
- Followed up with insured individuals regarding premium and deductibles payments.
- Analyzed information gathered by investigation and reported findings and recommendations.
Insurance Coordinator
Tampa Bay Institute Of Oral Surgery
01.2014 - 02.2020
- Prepared detailed reports outlining key metrics related to claim activity, enabling management to make informed decisions about resource allocation.
- Obtained prior authorization and precertification for outpatient procedures.
- Achieved revenue goals by managing collections and accounts receivables, referral process, and insurance billing.
- Coordinated communication between clients, adjusters, and repair facilities during the Pre Authorizations/claims process.
- Negotiated pre-authorizations for necessary dental procedures, securing coverage for vital treatments otherwise not covered.
- Monitored outstanding invoices and performed collections duties.
Education
Certified - Florida Certified Adjuster Licensed
Adjuster Pro
Online 01.2024
Associate of Science - Health Sciences, Business
Hillsborough Community College
Tampa, FL05.2016
Skills
- Bilingual
- Multi-line phone system
- Insurance Verification/regulations knowledge
- Pre Authorizations/Claims Handling
- Billing/ Data Entry
- Multitasking Abilities
- Analytical Skills/Problem-Solving
- Customer service expertise
- Database coordination
Certification
Certified Florida Insurance Claims Adjuster
Languages
Spanish
Native or Bilingual
Timeline
Treatment/Insurance Coordinator
Tampa Bay Institute Of Oral Surgery
05.2021 - Current
Insurance Coordinator
Tampa Bay Institute Of Oral Surgery
01.2014 - 02.2020
Certified - Florida Certified Adjuster Licensed
Adjuster Pro
Associate of Science - Health Sciences, Business
Hillsborough Community College
Certified Florida Insurance Claims Adjuster
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