Barbara Santiago
Barrigada,GUAM
Summary
To secure a position that will allow me to utilize my acquired skills and knowledge to provide a positive contribution in a professional business environment.
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level position. Ready to help team achieve company goals.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
22
22
years of professional experience
Work History
Senior Claims Processor
Moylan's Insurance Underwriters
07.2017 - Current
- Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Ensured accuracy of financial transactions related to claim payments, minimizing discrepancies in company records.
- Maintained high levels of customer satisfaction with efficient communication and prompt resolution of issues.
- Implemented new policies and procedures to enhance the overall efficiency of the claims department.
- Proactively prevented potential bottlenecks by consistently monitoring workload distribution among team members.
- Reviewed complex claims, utilizing expert knowledge to ensure proper coverage determinations were made.
- Supported continuous improvement initiatives within the organization by suggesting innovative solutions to challenges faced in the claims process.
- Identified fraudulent activities by conducting thorough investigations into suspicious claims.
- Maintained detailed documentation for each processed claim, allowing for easy retrieval during audits or reviews.
- Collaboratively resolved escalated issues by working closely with customer service representatives and adjusters.
- Mentored junior processors, enhancing their knowledge and skills for improved job performance.
- Managed high-volume caseloads, ensuring timely and accurate completion of claims processing tasks.
- Reduced errors in claims processing through rigorous quality control measures.
- Collaborated with cross-functional teams to improve overall claims management processes.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
- Followed up with customers on unresolved issues.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
- Evaluated accuracy and quality of data entered into agency management system.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Developed and implemented quality assurance processes to check accuracy of claims processing.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Generated, posted and attached information to claim files.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Posted payments to accounts and maintained records.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Calculated adjustments, premiums and refunds.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Coordinated with contracting department to resolve payer issues.
Claims Assistant
Alpha Insurers
03.2016 - 07.2017
- As a Claims Assistant, I attend to all claimants, interview them, and determine the nature of their claim; Provide the claimant with the appropriate forms and where necessary, I will assist them to complete the said claim forms; I will verify policy coverage before we can accept any claim; Create a file and claim number, once all documents are turned in; Request for VOC (Verification of Coverage); Provide management with a Weekly Report, which includes loss estimate and losses paid; Provide management with Outstanding Loss Report at the end of the month, which includes the reserve amount of all claims that are still open and being processed.
Administrative Assistant
Able Corporation
09.2015 - 01.2016
- Created, managed and organized all file systems and folders-hard copy and on the computer; Managed day-to-day operations for all construction sites; Scheduled and managed jobsite safety meetings, management and organization of construction office; General office duties; filing, mail, answering phones, etc.; Organized site meetings; Prepare and email Daily and Photographic Reports for project owner; Other duties as assigned.
Property Manager
RE/MAX Diamond Realty
03.2010 - 12.2013
- Advertise the availability of the property "for rent" and to display "for rent" signs; Negotiate leases on terms established by owner; Screen potential tenants as established by company guidelines; Execute lease agreements on behalf of owner; Collect rents, fees, and security deposits; Maintain receivables and payables in a Trust account; Serve notice to tenants for defaults and/or termination of tenancies; Point of contact for tenants; respond to tenant's complaints, concerns, and questions; Conduct move-in and move-out inspections with tenants; Solicit bids on behalf of owner; Hire, supervise, and discharge independent contractors required in the operation and maintenance of the property; Connect utilities on behalf of owner; Provide monthly "Income and Expense" statement to owner; Prepare and submit Gross Receipts Tax (mandatory government tax); Pay from gross receipts, all operating expenses and other expenses as instructed by owner; Provide tenancy and contract law information to owner as needed; Enforce house rules.
Maintenance Dispatcher/Admin
Fort Drum
09.2009 - 03.2010
- Dispatch work orders to maintenance technicians; Receive calls from residents that have maintenance problems in their home; Input work orders into Yardi, print out work orders and place them in each community to be issued out to technicians; Input technician notes into Yardi at the end of the day; Prepare timesheets, input into Yardi, print out recaps & verify; Create work orders for preventative maintenance that was performed during a certain day; Schedule appointments for residents who are due for preventative maintenance and for residents who prefer an appointment instead of technicians entering with a permission to enter; Take information down for Com Directives and Rent Ready homes.
Technical Support Professional I
Stream Global Services
01.2009 - 09.2009
- Helping customers solve a wide variety of technical problems and/or filling orders for products and offering suggestions that provide a more complete solution to their needs-some routine and straightforward, some complex and challenging; Part of a highly trained team of technical or sales professionals - interesting people from diverse backgrounds as unique as I am; Regularly access of state-of-the-art knowledge management database to research technical problems, offer advice to customers, and help sell new products; On the phone 7 hours a day and typically handle between 10 and 40 calls per day, depending on the product our company support and the type of solutions I provide; Access to a technical specialist who can help me work through especially difficult problems, or sales trainers who can help me match products to solutions; Well-organized and thorough in order to manage important details such as inputting customer data or completing sales or service orders; Expert in the product that I support or sell, learn valuable technical knowledge, problem solving skills, and state-of-the-art contact center tools; Provide world class customer service quickly and efficiently.
Receptionist/Administrative Assistant
Army Lodging
01.2008 - 08.2008
- Make reservations for incoming guests based on room availability; Post registration information on the registration card; Interviews incoming guests to determine room assignment; Assists clientele in the completion of required forms and registration cards; Answers billing questions and concerns; Assists soldiers or arranges transportation; Issues room keys; Answer questions pertaining to rules and regulations governing the assignment and use of quarters; Orients guests concerning use of facilities and equipment, and other facilities available on post; Accounts for and secures cash at end of shift.
Crew Member
Arby's Restaurant
03.2007 - 08.2007
- Receive payments by cash, credit cards, gift cards or automatic debits; Issued receipts, refunds and change due to customers; Greeted customers entering the establishment; Maintained a clean and orderly checkout area; Tabulated bills using a calculator, cash register or option price scanner; Resolved customer complaints and concerns; Scrubbed and polished counters and other equipment, cleaned glasses and fountain equipment; Served food, beverages and desserts to customers; Replenished foods at serving stations; Took customer's orders and wrote items on tickets, giving ticket stubs to customers when needed to identify filled orders; Stocked cabinets and serving areas with condiments, straws, napkins, cups, lids and refilled condiment containers as necessary; Located items requested by customers.
Medical Claims Analyst
Calvo's Insurance
06.2002 - 02.2004
- Received updated and processed data; Filed insurance claims and records; Maintained front desk area, answered telephone calls and greeted customers; Directed calls and customers to appropriate areas; Audited claims for medical facilities to ensure they met ICD-9 codes; Received, researched and resolved customer complaints; Processed necessary forms for payment operations; Received and mailed payments to medical providers; Researched, verified and processed insurance eligibility request.
Education
Diploma -
George Washington High School
01.2002
Skills
- 10-Key
- Active Learning
- Customer Service
- Data Collection
- Data Entry
- Documentation
- Executive Management Support
- Filing
- Grammar
- Internet Research
- Letters and Memos
- Microsoft Excel
- Microsoft Office Suite
- Microsoft Outlook
- Microsoft PowerPoint
- Microsoft Word
- Minute Taking
- Multi-Task Management
- Organizational Skills
- Prioritization
- Proofreading
- Reading Comprehension
- Report Transcription
- Scheduling
- Spreadsheets
- Telephone Skills
- Time Management
- Ability to perform office practices and procedures
- Screening calls and visitors
- Ability to perform routine clerical tasks readily and to adhere to prescribed procedures
- Locating and assembling information for various reports, and maintaining files/records
- Knowledge of correct grammar, spelling, punctuation, capitalization, and format to accurately prepare and edit written correspondence and reports, and transcribed material
- Vast knowledge of all office procedure and equipment
- Ability to work effectively with employees and public
- Self-motivated and able to work with little direction
- React quickly and work well under pressure
- Positive attitude and eager to take on new experiences
- Eager to try new things and a quick learner
- Manage time effectively to meet deadlines
- Able to follow instructions and directions in order to complete projects or assignments
- ICD-10 Coding Familiarity
- CPT coding knowledge
- Strong Communication Skills
- HIPAA Compliance Understanding
- Critical thinking abilities
- Training and mentoring
- Analytical Problem Solving
- Medical billing knowledge
- Claims Processing Expertise
- Claims Adjudication Experience
- Claims review
- Claims
- Transactions reconciliation
- Data entry proficiency
- Accuracy and Precision
- Teamwork and Collaboration
- Problem-Solving
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Organizing and Prioritizing Work
- Reliability
- Excellent Communication
- Critical Thinking
- Team Collaboration
- Active Listening
- Effective Communication
- Decision-Making
- Adaptability and Flexibility
- Claims Processing
- Relationship Building
- Microsoft Office
- Documentation skills
- Team building
- Claims adjustment
- Reporting skills
- Task Prioritization
- Excellent administrative abilities
- Self Motivation
- Prior authorization processing
- Goal Setting
- Insurance Claim Forms Review
- Policy Review
- Coverage Determination
- Documentation processing
- Time management abilities
- Insurance Coverage Verification
- Paperwork Processing
- Recordkeeping Organization
- Application Review
- Data Entry Software
Accomplishments
- Intro & Basics of Quickbooks Course - August 2012
- Guam No FEAR Act Training - June 2008
- New Employee Orientation - February 2008
- Prevention of Sexual Harassment - February 2008
- Customer Service Training - February 2008
Timeline
Senior Claims Processor
Moylan's Insurance Underwriters
07.2017 - Current
Claims Assistant
Alpha Insurers
03.2016 - 07.2017
Administrative Assistant
Able Corporation
09.2015 - 01.2016
Property Manager
RE/MAX Diamond Realty
03.2010 - 12.2013
Maintenance Dispatcher/Admin
Fort Drum
09.2009 - 03.2010
Technical Support Professional I
Stream Global Services
01.2009 - 09.2009
Receptionist/Administrative Assistant
Army Lodging
01.2008 - 08.2008
Crew Member
Arby's Restaurant
03.2007 - 08.2007
Medical Claims Analyst
Calvo's Insurance
06.2002 - 02.2004
Diploma -
George Washington High School
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