Background

I am currently a Senior Casualty Claims Adjuster and I have been employed by the automobile insurance industry for 9 years. In addition, I have held careers in IT and Quality Control as a manager and the healthcare industry as a Medical Biller. My careers over the years have required excellent time management skills, customer service satisfaction and accuracy in project management as well as team building. Although I have been heavily involved in a multitude of company projects over the years the accomplishments that I am most proud of are successfully launching a new Mid-Loss Branch for Mercury Insurance and becoming a manager in IT for CinemaNow. However, at this time in my career I am looking to further my future in either healthcare or management.

Job experience

• March 2016 - present
  Senior Casualty Adjuster
  Mercury Insurance Company
  

  Remote, CA

  • Managed an ever increasing workflow in a high volume call center environment while organizing and
  maintaining quality workmanship.
  • Refined workload approach to increase efficiency and shared developments with co-workers to promote
  team growth.
  Drafted and updated company workflow templates while mentoring new hires to minimize errors and
  maximize efficiency.
  • Experienced in arbitration and litigation between clients, automobile insurance, medical insurance companies, and any 3rd parties involved in a timely manner to find an agreeable resolution. Negotiated bodily injury claims of varying severity including fatalities with unrepresented, uninsured, and underinsured bodily injury claims between clients, law firms, and independent attorneys. Resolved numerous time-sensitive demands while adhering to their specific requirements to prevent an unnecessary exposure to the company and client(s).
  ● Reviewed medical records and billings including confirmation that the ICD-10 and CPT codes matched
  patient treatment. Resolve medical liens with Medicare, Medi-Cal, Medicaid, The Rawlings Company, Department of Healthcare Services, CMS, PPO and HMO healthcare plans. First rights to reimbursement such as Worksman's Compensation claims through Sedgewick.
  • Cultivated positive customer service and satisfaction consistently.
  • Engaged in active small claims court cases to provide key evidence and relevant vehicle codes for internal
  company attorney discovery purposes.
  • Secured documents with sensitive information and ensured only privileged parties would have access as necessary such as, but not limited to SIU (Special Investigation Unit) and EIU (Early Investigation Unit) and in house defense in order to detect and address fraudulent cases.
  • Assessed each claim individually to determine if management involvement was required immediately.. Applied all new company updates for audit guidelines to ensure all audits were error free.
  • Issued timely payments as determined by superiors when outside of authority and similarly when within authority.
  • Manually composed all government mandated notices within their necessary timeline for each
  individual involved.
  • Organized, prioritized and addressed all Emails, voice messages, in coming calls, faxes, text messages and desktop tasks in a timely manner while providing quality service for customers, healthcare providers law offices and internal company members.
  • Point person for liability determinations among peers.
  
  Accomplishments:
  • Assisted employees with workplace set-up and technical issues.
  • Mentor for new hires due to limited remote training as a result of COVID-19.
  Honorable mention for consistency with an audit score which ranked in the top 20th percentile company
  wide.
  • Pioneered a new mid-loss branch that handled high priority claims from start to finish while perfecting
  overall file quality and coaching prior insurance adjusters on process improvement to eliminate future
  errors.
  

• January 2025 - June 2025
  Medical Biller
  Santa Clarita Valley Therapy Services
  

  Santa Clarita, CA, USA

  • Processed and submitted clean and accurate claims to insurance companies. Including, but not restricted to primary, secondary and tertiary insurance companies with a focus in workman's compensation claims.. Submitting and securing extensions for treatment after careful review of the physician's notes and recommendations based on the diagnosis and prognosis in regards to the patient's needs.
  HIPPA compliant. Reviewed medical records coding for accuracy in regards to billing and treatment while consulting with
  the therapist for any inaccuracy to ensure that the billing was precise.
  • Diligently followed-up on collections, unpaid or denied claims to ensure prompt payment.
  ● Negotiated attorney liens in order to reach an amicable resolution to close the account.
  ● Verified eligibility with insurance companies including but not limited to Medi-Cal, Medicare, and Medi-Caid regarding HMO and PPO.
  

• September 2013 - February 2016
  Encoding Manager
  CinemaNow
  

  Culver City, CA, USA/ Dissolved

  • Point person for the release of all features and Next Day TV related content for major studios and non-studios: Lionsgate, Disney, Starz, Sony, Universal, Paramount, HBO, Warner Bros., eOne, StudioCanal, Magnolia, Millennium and Alchemy.
  Responsible for quality assurance, control of content workflow and daily research for new tools to
  improve workflow efficiency.
  • Mentor for encoding team on customer service skills and content related issues to maintain and strengthen
  studio relations.
  • Resolved all escalated issues pertaining to processing content, including solutions for trouble shooting
  and perfecting all ingestion tools utilized by CinemaNow.
  Managed a 65,000 title digital media library.
  • Documented and organized large volumes of information including, but not limited to mezzanine
  files, closed captions, metadata, and boxart.
  Coordinated workstation set-ups, training, and positive re-structuring of workflow/process improvement
  for encoding team members at CinemaNow, Century City, CA branch.
  
  Accomplishments:
  • Collaborated with engineering for process improvement involving new encoding and content
  management pipelines for Amazon/S3 environment.
  • Lead migration from TotalCode Encoder to AWS Elastic Transcoder and Amazon Elemental Encoder.
  Built all profiles and presets for new encoders. Elemental mini-mezzanine preset solution for ProRes to MP4 conversion to by-pass AWS Transcoder limitations on processing ProRes.
  • Created and implemented solutions for playback issues on all CinemaNow's platforms. Advised encoding team on all mezzanine repairs. Built AWS Elastic Transcoder preset solutions for Roku 3 and Android.
  ● Oversaw cloud migration of new release content and the structure of studio profiles for CinemaNow's new cloud based Aspera.
  • Point-person for expertise on mezzanine naming conventions, file format, audio channel set-up, aspect ratios, frame rates, and closed captions for the revision of CinemaNow's studio onboarding documents.
  • Point person for CinemaNow with the completion of a 35,000 title closed caption backfill project.
  

• January 2011 - September 2013
  Quality Control Specialist
  Rovi Entertainment Store
  

  Burbank, CA, USA

  • Processed digital library content, tracked and updated Features, Next Day TV, mezzanine asset repair and
  backfill Google documents.
  • Reported bugs while troubleshooting ingestion tools and monitoring video playback in QA testing
  environments.
  • Documented playback issues involved but were not limited to video corruption, audio corruption, improper
  aspect ratios for unprocessed and processed mezzanine files, out of sync closed captions, missing closed captions, rating cards for improper territories, improper subtitles, and incomplete credits.
  • Completed daily workload professionally and efficiently. Kept a strong line of communication on all
  content related issues with supervisors, content ops and encoding team members.
  • Set-up employee workstations, trained and monitored efficiency of workflow for new QA hires at
  Rovi Burbank, CA branch.
  
  Accomplishments:
  • Point person for Next Day TV Encoding lead with re-encoding and QA for significant Network ID
  backfill project.
  ● Point person for Feature Encoding Lead with re-encoding and QA for significant Disney Episodics
  and trailer backfill projects.
  • Point person for Feature Encoding Lead with rating card editing solution for UK territories using Rhozet
  Encoder.
  

Education

• Central Connecticut State University
  BA - Bachelors of Arts
  

  2005 - 2007
• Naugatuck Valley Community College
  AA - Associates of Arts
  

  2002 - 2005