Kim Huling
Macon
Summary
Claims Specialist with 5+ years' experience working in a professional setting, currently working towards a Bachelor's in Criminal Justice with a strong interest in investigation, analyzing and conflict resolution. Highly organized, dedicated, with a positive attitude. Mentor and leadership capabilities, capable of handling multiple assignments, with little direction or supervision. Excellent customer service skills and confidence in handling day to day office duties.
Overview
11
11
years of professional experience
Work History
Property Claims Specialist
State Farm
09.2022 - Current
- Handles claims that do not need a physical inspection and are expected to close in a short timeframe
- Resolves a large volume of claims in an in office environment through investigation, evaluation, negotiation, verification of coverage and extent of damage to property
- Prepares and/or reviews property estimates and contents estimates in loss settlements
- Examines claims submitted by insureds and/or third parties, or claims referred from other claim units, to determine whether additional or specialized investigation is necessary for claim resolution
- Assisted clients in navigating the complexities of the insurance claim process, providing clear explanations and guidance when needed.
- Coordinated with contractors and vendors for prompt repair or replacement of damaged properties, minimizing downtime for clients.
- Mentored new to role team members on best practices in property claims management, fostering professional growth within the team environment.
- Examined policies and endorsements to determine insurance coverage.
Michigan Claims Team Lead
Kemberton Healthcare
08.2020 - 09.2022
- Investigating and coordinating insurance benefits for auto accidents on behalf of the medical provider (handling state MI)
- Resolving accounts as quickly and accurately as possible, obtaining maximum reimbursement for Med Pay, PIP, TPL, Work Comp and health insurance
- Performing investigative and follow up activities in a fast-paced environment by conducting research, contacting patients, insurance companies and attorneys, sending out claim submissions (UB04/HCFA bills, medical records, and any other supporting documents) via fax and/or mail
- Negotiating reduction of charges with Attorneys and untimely PIP interest charges with Auto insurance PIP Adjusters
- Reviewing and understanding medical bills, correspondence received, and maintaining along with prioritizing a designated work queue
- Remaining well organized with reporting, spreadsheets, and Attend client calls as needed
- Mentoring team on productivity, process improvement, and company standards
- Appeal health and auto insurance denials according to the Cofinity contract, fee schedule, or Medicare guidelines
- Additional Team Lead/Management duties as assigned
Claims Analyst II
Aspirion Health Resources
03.2017 - 08.2020
- Investigating and coordinating insurance benefits for accident claims for auto, home or other liability insurance policies
- Account/claim resolution as quickly and accurately as possible, obtaining maximum reimbursement (Med Pay, PIP, BI, AND UM/UIM claims)
- Performing investigative and follow up activities in a fast-paced environment by conducting research, contacting patients, insurance companies and attorneys
- Handling incoming and outgoing mail, scanning and indexing documents and handling any other tasks that are assigned
- Being well organized
- Negotiating reductions with Attorneys using a predetermined formula based upon the facts of loss
- Build rapport and relationships with patients, attorneys, and insurance adjusters regarding obtaining information to move the account to the next phase
- Load and close accounts
- Send weekly closing lists to hospital contacts
- Assist with recons and monthly cycle counts
- Proficient knowledge of Meditech Magic, Meditech 6.0, Paragon, Epremis, and One Content
- Daily contact with the hospital building trust, relationships, and meeting weekly account deadlines by reviewing attorney, patient, adjuster, and hospital correspondence
Data Entry Intent Analyst
U.S. Virtual Careers
11.2015 - 03.2017
- Listen to customers making calls into an automated system with requests for customer service under a globally known smartphone provider
- Accurately routed customers to the intended department based upon their intent
- Successfully passed and obtained multiple upskills based upon previous performance
- Maintained a below 2.5 second response time on intents
- Client has renewed 3 month contracts 3 separate times based upon meeting their performance requirements
Teller I
Wells Fargo
08.2014 - 11.2015
- Process Deposits, Withdrawals, Transfers, and Payments
- Prepare money orders and cashier's checks
- Adhering to Federal FDIC Regulations and Company Policies
- Receive checks and cash for deposit, verify amounts, and check accuracy of deposit slips
- Balance currency, coin, and checks in cash drawers at ends of shifts, and calculate daily transactions using computers, calculators, or adding machines
- Examine checks for endorsements and to verify other information such as dates, bank names, identification of the persons receiving payments and the legality of the documents
Education
Bachelor's - Criminal Justice
Columbus State University
Columbus, GA05.2023
Internship -
Columbus Probation Office
05.2015
Skills
- Investigation
- Analyzing
- Conflict resolution
- Organization
- Dedication
- Positive attitude
- Mentoring
- Leadership
- Multi-tasking
- Customer service
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- Claims investigation
- Attention to detail
- Claims resolution
- Reliability
- Insurance regulations
Preferred Name
Kim
Timeline
Property Claims Specialist
State Farm
09.2022 - Current
Michigan Claims Team Lead
Kemberton Healthcare
08.2020 - 09.2022
Claims Analyst II
Aspirion Health Resources
03.2017 - 08.2020
Data Entry Intent Analyst
U.S. Virtual Careers
11.2015 - 03.2017
Teller I
Wells Fargo
08.2014 - 11.2015
Internship -
Columbus Probation Office
Bachelor's - Criminal Justice
Columbus State University
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