Rona Marie R. Palacios
PMB 111 535 Chalan Pale Ramon Haya, Suite 116 Yigo,,Guam
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Detail-oriented Insurance Claims Specialist driven to resolve claims fairly while representing interests of employer. Conducts thorough and informed investigations, precisely evaluates losses and negotiates settlements that satisfy diverse parties. Builds and maintains professional and productive relationships and works to understand potentially conflicting points of view.
Overview
24
24
years of professional experience
Work History
Insurance Claims Processor / Subrogation Officer
Nanbo Insurance
Hagatna , Guam
03.2000 - 12.2007
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
- Maintained accurate records of all processed claims in accordance with departmental requirements.
- Reviewed and evaluated subrogation claims to determine potential recovery opportunities.
- Prepared detailed reports outlining all pertinent information for each claim.
Customer Service Representative /Insurance Underwriter
Nanbo Insurance
Hagatna, Guam
01.2007 - 10.2018
- Identify prospects and provide premium quotations for automobile policies
- Process payments, contact clients for renewals, and collections
- Reviewed and evaluated customer's applications to determine eligibility for insurance coverage.
- Negotiated with customers regarding policy terms and conditions as needed.
- Identified opportunities to improve underwriting processes or procedures.
- Provided guidance and support to junior staff members in the underwriting process.
- Negotiated coverage, policy pricing and service delivery during meetings with customers, agents or brokers.
Customer Service Representative/Insurance Underwriter
Guahan Insurance Services
Tamuning, Guam
10.2018 - 01.2019
- Identify prospects and provide premium quotations for automobile policies
- Process payments, contact clients for renewals, and collections
- Reviewed and evaluated customer's applications to determine eligibility for insurance coverage.
- Negotiated with customers regarding policy terms and conditions as needed.
- Identified opportunities to improve underwriting processes or procedures.
- Provided guidance and support to junior staff members in the underwriting process.
- Negotiated coverage, policy pricing and service delivery during meetings with customers, agents or brokers.
Claims Administrative Assistant /Subrogation Specialist
Guahan Services
Tamuning, Guam
01.2019 - Current
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Investigated complex or high-value claims to identify discrepancies and fraud indicators.
- Researched medical records to evaluate claim validity and verify the existence of pre-existing conditions.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Compiled data from multiple sources for reporting purposes.
- Interpreted legal documents related to claims processing such as contracts and policy language.
- Provided customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Collaborated with other departments within the organization to resolve issues related to claims processing.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
Education
High School Diploma -
Simon Sanchez High School
Yigo, Guam06-1989
Skills
- Computer Skills: Microsoft Office (Microsoft Word, Excel, and Outlook)
- Office Equipment: Fax Machine & Copy Machine
- Clerical Skills
- Claims Handling
- Sales Support
- Data Interpretation
- Policy evaluation
- Risk Assessment
- Effective Communication
- Interpersonal Skills
References
- Guillermo Bagiac 671-475-5705
- Marcia Lujan 671-475-5700
Timeline
Claims Administrative Assistant /Subrogation Specialist
Guahan Services
01.2019 - Current
Customer Service Representative/Insurance Underwriter
Guahan Insurance Services
10.2018 - 01.2019
Customer Service Representative /Insurance Underwriter
Nanbo Insurance
01.2007 - 10.2018
Insurance Claims Processor / Subrogation Officer
Nanbo Insurance
03.2000 - 12.2007
High School Diploma -
Simon Sanchez High School
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