Lashonda Mayfield

About Lashonda Mayfield

Self-motivated professional with more than a decade experience managing insurance and…

Experience

1. Subrogation Negotiator

   Claritev

   Jul 2015 — Present

   Handle subrogation recovery claims from beginning through to settlement. Undertake claims settlement negotiations against 3rd parties within authority. Report to clients regarding recovery potential and claim status. Recommend settlement and/or seek approval to accept settlement offers. Support the legal department with respect to recovery documentation, protect recovery rights. Keep clients informed regarding subrogation potential.Responsibilities:• Coordinate claims payment among health plans and other responsible insurance carrier(s) • Subject Matter Expert regarding the subrogation/coordination process• Review payment ledgers from other insurance; validate duplications• Make demands of other insurance carriers arguing primacy of coverage• Follow client specific procedures and guidelines• Ability to adapt to process change and help improve and implement new processes• Identify and develop subrogation opportunities• Research and request case information to develop claims• Send notification to parties of interest regarding claims• Develop and maintain records via a calendar diary for all claims activities• Respond timely to all electronic, written, and verbal communications• Log information derived from written and verbal communication; where required maintain detailed and accurate records worker’s compensation, first and third party, med-pay coverage, and no-fault recoveries• Engage advice and/or help of management to proactively resolve cases• Understand basic health plan contractual provisions and apply to the reimbursement efforts• Ensure compliance of state and federal laws• Provide feedback to Management and unit on trends or developments• Access and pull benefits from clients’ remote health claim systems• Maintain department productivity and quality standards• Sensitivity to privacy in accordance with HIPAA guidelines

Education

• Wright College

  Business

  1993 — 1994

• City Colleges of Chicago-Wilbur Wright College

  Business Administration and Management, General

Skills

• Call Centers
• Business Development
• Negotiation
• Trading
• Sales Operations
• International Business
• Customer Service
• Marketing
• Marketing Strategy
• Insurance
• Account Management
• Sales
• Team Building
• Management
• Strategic Planning
• Export
• Leadership
• Training
• Sales Management
• New Business Development
• Purchasing