Mary Oliveros
Winnipeg
Summary
Analytical problem-solver with excellent communication skills. Effective and efficient at analyzing claims, verifying information, compiling records and documenting findings. Well-versed in insurance policies, practices and standards.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Claims Representative
Manitoba Blue Cross
11.2020 - Current
- Adjudicates and processes standard and diverse Health Spending Account, Extended Health, Prescription Drug, Vision, and Dental claims in accordance with performance standards.
- Communicates with members and providers during the course of claims assessment.
- Adjudicates and processes claims for coordination of benefits.
- Manages and updates Coordination of Benefits (COB) information received from Information/Customer Services and Client Administration.
- Responds to customer inquiries, particularly those of a complex nature.
- Researches and analyzes complex claims to determine next steps and possible outcomes.
- Improves customer satisfaction by providing timely and accurate information on claim status and resolution.
- Examines documents to determine integrity and accuracy of information.
- Analyzes and addresses escalated claims to resolve issues quickly.
- Assists new Claims Representatives on company policies, procedures, software systems, and improving overall team productivity.
- Works productively in fast-moving work environment to process large volumes of claims.
Chiropractic Assistant
Maples Chiropractic
10.2019 - 12.2019
- Answers phones to respond to customer questions, provides information and schedules appointments.
- Developed strong rapport with patients leading to high levels of trust and satisfaction, fostering long-term relationships.
- Checks and informs the patients of their insurance coverage.
- Prepared examination rooms with necessary equipment, promoting efficient appointment flow while prioritizing sanitation protocols.
- Educated patients on chiropractic care benefits, resulting in increased referrals and new client acquisition.
College Instructor
Cavite State University Main Campus
07.2010 - 12.2016
- Teaches Business Economics, Business Mathematics, and Statistics
- Prepares course syllabi, handouts, and other teaching materials needed and outlined in the course.
- Works closely with academic advisors to identify at-risk students early in the semester and develop targeted intervention strategies for increased retention rates.
- Develops strong relationships with students through clear communication and active listening, fostering an inclusive classroom environment.
Education
Diploma - Logistics And Supply Chain Management
Robertson College
Winnipeg, MB10.2021
Bachelor of Science - Business Economics
Cavite State University
Indang, Cavite, Philippines04.2009
Skills
- Microsoft Office, Proficient
- SAP, Microsoft Teams and Zoom Proficient
- Claims Investigation and Processing
- Time Management
- Decision-Making
- Attention to Detail and Critical Thinking
- Teamwork and Collaboration
- Eligibility Determination
- Insurance Coverage Verification
- Medical Terminology
Accomplishments
- Achieved a 100% average yearly productivity in 2023 with minimal processing error.
- Achieved my highest monthly productivity of 131% on February 2024.
- Included in the Special Processing Group that handles payment plans, Audits, Wellness Spending Account, and escalated memos from clients.
Languages
Tagalog
Native or Bilingual
English
Native or Bilingual
Certification
- LOMA 281 - Meeting Customer Needs with Insurance and Annuities 3rd Edition
- Licensed Financial Advisor in Manitoba and Alberta from June 2022 to April 2024 (Life Insurance, Segregated Funds and Annuities, and Accident & Sickness Insurance,)
Timeline
Claims Representative
Manitoba Blue Cross
11.2020 - Current
Chiropractic Assistant
Maples Chiropractic
10.2019 - 12.2019
College Instructor
Cavite State University Main Campus
07.2010 - 12.2016
Diploma - Logistics And Supply Chain Management
Robertson College
Bachelor of Science - Business Economics
Cavite State University
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