Alisha Espinoza
Tifton,GA
Summary
Organized and dedicated Resolution Manager and Claims Adjuster with proven track record of providing exceptional management and customer service in fast-paced environments. Offering keen attention to detail and strong decision making skills to manage multiple, concurrent tasks. Self-motivated work ethic with ability to perform effectively in independent or team environments. Ability to minimize losses by quickly handling claims and supporting effective litigation processes.
Overview
23
23
years of professional experience
Work History
Resolution Manager/Claims Adjuster
Custard Insurance Adjusters
08.2011 - Current
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
- 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.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Resolved complex, severe exposure claims using high service oriented file handling.
Administrative Assistant/Human Resources Payroll Specialist
Tift Health Care
06.2008 - 07.2011
- Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments
- Transmit information or documents to customers using computer, mail, or facsimile machine
- Resolve complaints from employees regarding payroll
- Perform administrative support tasks such as proofreading, transcribing handwritten information, use computers to work with pay records, invoices, balance sheets, and other documents
- Collect, sort, distribute, and prepare mail deliveries
- Process and prepare memos, correspondences and other documents
- Keep a current record of staff members whereabouts and availability
- Executed record filing system to improve document organization and management.
- Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
- Assisted coworkers and staff members with special tasks on daily basis.
- Managed paper and electronic filing systems by routing various documents, taking messages and managing incoming and outgoing mail.
- Resolved payroll discrepancies quickly and successfully.
- Verified and submitted timekeeping information for accurate and efficient payroll processing.
- Uploaded time records into computer system and made adjustments to create accurate database for payroll processing functions.
Assistant Manager
Speedee Cash
12.2006 - 08.2007
- Verify and examine information and accuracy of loan application and closing documents
- Interview loan applicants in order to obtain personal and financial data and assist in completing applications
- Assemble and compile documents for title pawns
- Answer questions and advise customers regarding the loans and transactions
- Present loan and repayment schedules for customer's acceptance
- Contact credit bureaus, employers, and other sources in order to check applicant's credit and personal references
- File and maintain loan records
- Accept payments on accounts
- Review customer accounts in order to determine whether payments are made on time and that other loan terms are being followed
- Establish credit limits and grant extensions of credit on overdue accounts
Office Assistant
Turner's Fine Furniture
11.2005 - 12.2006
- Complete loan applications, including credit analyses and summaries of loan requests and submit to loan committees for approval
- Confer with customers by telephone and in person to provide information about products and services, take and enter orders
- Setup deliveries based on a daily schedule
- Calculate payroll for the main store
Insurance Collector
Tift Regional Medical Center
06.2004 - 05.2005
- Prepare insurance claim forms or related documents and review them for completeness
- Post and attach information to a claim file
- Transmit claims for payment and further investigation
- Contact insured or other involved persons to obtain missing information
- Set up payment plans
- Assist patients with any questions or concerns regarding their account
Insurance Biller/Collections
Lifeline Homecare
09.2003 - 06.2004
- Contact new and existing customers to discuss their needs and explain how these needs could be met by specific products and services
- Quote prices, credit terms and other specifications
- Maintain customer records using automated systems
- Prepare sales contracts for orders obtained and submit orders for processing
- Complete expense reports, sales reports, and other paperwork
- Follow up on claim denials
Acccounts Receivable
Family Practice Associates
04.2001 - 09.2003
- Arrange for debt repayment and establish repayment schedules based on patient's financial situation
- Advise patients of necessary actions and strategies for debt repayment
- Locate and notify patients of delinquent accounts by mail, telephone and in person
- Confer with patients by telephone and in person to determine reasons for overdue payments and review the statements with customers
- Answer questions regarding problems with the accounts
- Perform various administrative functions for assigned accounts such as recording address changes and purging records of deceased patients
- Receive payments and post payments to customer accounts
- Contact insurance companies to check the status of claim payments and write appeal letters for denials on claims
- Check patients in and enter their information in the computer
Education
Associates In Claims - Claims Examination
The Institutes
Intro To Business - Business
Abraham Baldwin Agricultural College
Tifton, GA06.2006
High School Diploma -
Worth County High School
Sylvester, GA05.1999
Skills
- Data analysis
- Insurance policy coverage knowledge
- Data collection and analysis
- Multi-tasking
- Data entry background
- Proofreading and editing
- 65 WPM Typist
- Claims Reviewing
- Litigation Support
- Policy Development
- Decision Making
- Staff Supervision
- Event Coordination
- Performance Evaluation
- Financial Analysis
- Conflict Resolution
- Strategic Planning
- Quality Assurance- File Reviews
- Risk Management
- Process Improvement
- Training and Development
- Organizational Skills
- Office Supervision
- Employee Hiring/Onboarding/Training
- Accounting Procedures
- Payroll Control
- Recordkeeping and Reporting
- Analytical and Critical Thinking
Timeline
Resolution Manager/Claims Adjuster
Custard Insurance Adjusters
08.2011 - Current
Administrative Assistant/Human Resources Payroll Specialist
Tift Health Care
06.2008 - 07.2011
Assistant Manager
Speedee Cash
12.2006 - 08.2007
Office Assistant
Turner's Fine Furniture
11.2005 - 12.2006
Insurance Collector
Tift Regional Medical Center
06.2004 - 05.2005
Insurance Biller/Collections
Lifeline Homecare
09.2003 - 06.2004
Acccounts Receivable
Family Practice Associates
04.2001 - 09.2003
Associates In Claims - Claims Examination
The Institutes
Intro To Business - Business
Abraham Baldwin Agricultural College
High School Diploma -
Worth County High School
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