Insurance Specialist – I Quote Plus, Inc
Round Rock, TX
Seeking a challenging and rewarding position utilizing excellent organizational, administrative and communication skills. Ability to work well with others or independently with consistency and attention to detail. Well developed communication skills, including written, verbal and interpersonal.
2014 to Present
Worked with individuals to provide Health Insurance or Medicare Supplement plans.
• Completed online and written applications with insurance carriers.
• Worked with clients in person, over the phone and by email.
• Specialized in Medicare supplement plans for seniors.
2008 to 2014
• Handled Workers’ compensation medical claims for school district employees.
• Reviewed and investigated new claim assignment’s including phone interviews with injured employee.
• Initiated benefit payments within appropriate deadlines and set appropriate medical expense reserves.
• Reviewed and released medical payments for each claim assignment.
Benefit Claims Administrator II
2006 to 2008
• Audited Workers’ compensation medical, pharmacy and hospital claims according to Texas fee guidelines.
• Processed medical claim appeals and completed necessary data entry corrections.
• Handled phone inquiries from health care providers, claim adjusters and other clients or customers.
2002 to 2006
• Audited Workers’ compensation medical and dental claims according to Texas fee guidelines.
• Determined payment or denial according to company policies and fee guidelines.
• Processed recovery letters for overpayment’s.
• Handled incoming phone calls from Medical providers and claims adjusters.
1999 to 2002
Processed Medicare and Medicaid claims according to State fee guidelines.
• Processed and entered data from health claim forms into image system and data base.
• Maintained tracking reports and daily production figures.
High School Diploma
SKILLS & SPECIALIZED TRAINING
• Proficiency in Microsoft applications, including Word, Excel and Outlook. Typing 55 wpm and 10 key by touch skills.
• Active and current State of Texas Adjuster license and State of Texas General lines agent license.