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Obtained promotion within company to Medical Only Claims Specialist after short period as Claims Assistant. Applied initiative to voluntarily learn new claims system. Investigated medical workers’ compensation claims in several states to determine appropriate compensation and claim resolution in collaboration with claimants and policyholders. Worked with Special Investigation Unit to identify fraud and Subrogation for deductibles. Notified policyholders and claimants, completed and filed reports, Medicare reporting and documented activity and decisions, all in accordance with State Workers’ Compensation Statute. Utilized Nurse Case Management services, independent medical examinations, referral for rehabilitation, utilization reviews, and other claims management resources. Established case reserves, processed medical payments and approved legal budgets.

Processed new claim files, including mailing notices and forms to required parties, Medicare submissions, and maintaining claim data. Handled incoming calls from providers, claimants, policyholders, attorneys, and agents. Analyzed State Workers’ Compensation Commission form requirements and claim information before submitting in electronic and paper formats; troubleshot rejections in collaboration with vendors and state bureaus. Processed medical and legal payments and approved weekly and biweekly wage payments. Stamped, identified, and distributed daily mail to appropriate claims specialists. Supplied either hard copy or electronic version medical records and documents to vendors, attorneys, and invested parties. Demonstrated capability by assisting four claims specialists; one more than ordinarily undertaken by other assistants. Received recognition for excellent performance and for proactively assuming additional work not required and not taken by other assistants.

Processed corrections and adjustments of Medicare Part B claims. Ensured corrections and adjustments were accurate by reviewing audits and policies for denials. Resubmitted incorrectly filed claims with the provider’s appropriate corrections.

Analyzed data for consistency and accuracy. Trained and supported database internal users in database guidelines, thereby maintaining database integrity. Noted recurring issues and provided solutions while working with the technology teams and the data system supervisor.

Recommended for Preschool Secretary position based on excellent performance as previous Classrooms for the Future Secretary. Delivered secretarial tasks, to include answering the phone, filing, data entry, and managing Outlook; also prepared and distributed paperwork for the educational staff. Solved problems, answered questions, and provided hands-on support with the new information system while assisting the educational staff.

Performed general secretarial duties and created and managed documents and spreadsheets. Worked with 501 school districts, employing solid patience, tracking skills, proofreading, and time management aptitude. Administered the program’s website, Google Docs, and Wikis. Worked with a three-person team to successfully supply all participating schools with laptops, delivering on time and within required parameters. Reviewed Final Expenditure reports for approval.

Created a Sheriff Sale Process and was promoted to Senior Paralegal.Compiled case information for court appearances. Provided direct support to the attorneys including maintained the attorney’s calendar. Processed incoming correspondence from courts, debtors, and third parties.

Executed summons for the process of bank garnishments, liens, and judgments.Managed daily 100 civil action judgments. Created a Sheriff Sale process, executed and attended sheriff sales.