Margaret Howard
Chesapeake
Summary
Dynamic professional with extensive experience in insurance claims management and customer service. As a Claims Adjuster at USAA, I successfully negotiated settlements and ensured compliance with regulations. Proven ability to make critical decisions and maintain data security, while optimizing processes to enhance operational efficiency.
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
7
7
years of professional experience
Work History
Daycare Owner/Operator
Rising Stars Childcare LLC
07.2021 - Current
- Maintained accurate accounting of tuition and operating reports.
- Maintained high-quality child care standards based on developmentally appropriate practices.
- Implemented school policies, procedures, and systems to promote safe and healthy environment in compliance with state standards.
- Oversaw safety requirements, inspection, and certification procedures to facilitate annual licensing review.
- Established and optimized program schedules to cover planned needs while capitalizing on opportunities to improve student learning.
Claims Adjuster
USAA
01.2021 - 09.2023
- Verified insurance claims and determined fair amount for settlement.
- Prepared summaries of damage, payments, and policy coverage.
- Examined claims forms and other records to determine insurance coverage.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
Claims Processor
Optima Health Insurance
05.2018 - 01.2021
- Managed large volume of medical claims on daily basis.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Monitored and updated claims status in claims processing system.
Education
High School Diploma -
I. C Norcom High School
Portsmouth, VA06-2023
Skills
- Insurance claims management
- Critical Decision-making
- Healthcare billing
- Insurance verification
- Data security procedures
- Customer service
- Medical record review
Timeline
Daycare Owner/Operator
Rising Stars Childcare LLC
07.2021 - Current
Claims Adjuster
USAA
01.2021 - 09.2023
Claims Processor
Optima Health Insurance
05.2018 - 01.2021
High School Diploma -
I. C Norcom High School
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