Virginia Embry
Gallatin,TN
Summary
Analytical problem-solver with excellent communication skills. Effective at interviewing customers, compiling records and documenting findings. Well-versed in insurance policies, practices and standards. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure a Claims Specialist position.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Express Claims Associate
State Farm
10.2022 - Current
- Worked productively in fast-moving work environment to process large volumes of claims.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Collaborated with internal departments and external vendors to achieve fast resolution of claims.
- Followed up with customers on unresolved issues.
- Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
Registered Nurse
United Health Care
05.2019 - 01.2020
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Responded promptly and professionally to patient questions and concerns.
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
Home Health Registered Nurse
Willowbrook Home Health
12.2018 - 05.2019
- Informed physicians of any changes to patients' health or concerns observed during home visits.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Traveled to patients' homes on daily basis to assess health conditions and provide superior level of nursing care.
- Incorporated therapeutic, rehabilitative and nursing goals into detailed, individualized care plans based on diagnoses.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
Registered Nurse
Board Of Education
01.2016 - 12.2018
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
Education
Bachelor of Science - Nursing
Cumberland University
Lebanon, TN05.2012
Associate of Science - Pre-Nursing
Volunteer State Community College
Gallatin, TN05.2010
Skills
- Policy Knowledge
- Documentation Research
- Settlement Determinations
- Accident Investigations
- Accident Review
- Claims Evaluations
- Liability Determinations
- Claims Inspections
- Customer Relationship Management
- Coverage Determination
Certification
- Licensed Adjuster in all required states
Timeline
Express Claims Associate
State Farm
10.2022 - Current
Registered Nurse
United Health Care
05.2019 - 01.2020
Home Health Registered Nurse
Willowbrook Home Health
12.2018 - 05.2019
Registered Nurse
Board Of Education
01.2016 - 12.2018
Bachelor of Science - Nursing
Cumberland University
Associate of Science - Pre-Nursing
Volunteer State Community College
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