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Alejo
Claims Adjudicator Health Insurance
Contact
Competencies
Demonstrated experience with Claims Review and Approval.
Demonstrated experience with Health Insurance Administration.
Demonstrated experience with Claims Auditing.
Demonstrated experience with Medical Authorizations.
Demonstrated experience with Provider Coordination.
Education
Languages
Summary
Claims Adjudicator Health Insurance open to new opportunities
Experience
Human Resources Assistant
Reviewed and validated employee offboarding cases across global operations, supporting accurate and consistent processing.. Updated and maintained HR documents and templates used in employee separation processes.. Scheduled and delivered webinars on offboarding rules and procedures for local employees.
Administrative Assistant, Occupational Health Unit
Evaluated documentation for pre-employment and periodic medical examinations for local employees in Africa and the Americas.. Coordinated pre-employment medical examinations for international employees.. Reviewed and approved medical authorizations for employee travel.
Medical Claims Assistant
Audited and approved medical claims in accordance with applicable medical plan requirements.. Prepared guarantee letters for healthcare providers to support access to covered medical services.. Reviewed and approved new employee enrollments in the medical plan.. Delivered seminars on employee benefits and medical coverage, including assignments in Kenya and Somalia in 2016.
Medical Claims Analyst
Analyzed medical insurance claims and supported local claims processing in Panama.
Medical Claims Analyst
Analyzed medical insurance claims and supported local health insurance operations in Panama.