Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

ESTHER M. APONTE

Brooklyn,NY

Summary

Qualified Claims Representative versed in investigating initial and post entitlement claims, verifying information and managing settlements for monthly/retro-active payments along with developing and processing overpayments and underpayment issues. Friendly and upbeat team player with organized and disciplined approach. Offering 36 years of public service experience. Hardworking customer service professional knowledgeable about claims processes. Proven history of best-in-class service and understanding of company protocols. Dedicated to integrity and honest work. Background includes retirement, disability, survivor and family auxiliary along with medicare claims, processing and developing in fast-paced environments. Adept at handling complicated claims from first contact through final settlement. Developing all post entitlement issues regarding claim, entitlement, payment or medicare issues. Fluent in English. Analytical problem-solver with excellent communication skills. Effective at interviewing the public, compiling records and documenting findings. Well-versed in policies, practices and standards. Detailed claims Clerk with demonstrated commitment to organization, service and professionalism. Excellent computer and communication skills with exceptional knowledge of all claims and policies. 70 Wpm type speed with 95% accuracy combined. Proficiency in Microsoft Word, detail-oriented retirement claims Specialist versed in researching and resolving complex issues on behalf of the public. Bringing 36 years of expertise in retirement and disability claims. Gifted in working with stressed, confused and upset individuals in need of benefit information and supportive guidance to navigate benefits systems. Effectively trained in diffusing irate situations with the public along with congressional issues. Effective at operating within company regulations and department guidelines to manage telephone calls, emails, letters and in-person requests for assistance. Dedicated professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Excellent reputation for resolving problems and improving customer satisfaction. Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in retirement practices and standards. Enthusiastic Claims representative , eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of back office and training in stressful claimant defusing. Motivated to learn, grow and excel .. To seek and maintain a position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

Overview

36
36
years of professional experience

Work History

Claims Representative

Social Security Administration
Brooklyn, New York
09.1995 - 01.2022
  • Evaluated accuracy and quality of data entered into claimants social security records.
  • Followed up with customers on unresolved issues.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Calculated and posted payments and billing to overpaid and underpaid claimant records.
  • Reviewed outstanding requests and redirected workloads to complete projects on time.
  • Verified client information by analyzing existing evidence on file.
  • Maintained confidentiality of claimant finances, personal records and health statuses.
  • Examined applications and evidence supplied by claimants to determine integrity and accuracy of information.
  • Interviewed and adjudicated to completion retirement, disability, survivor and family auxiliary applications.
  • Responded to emails and other correspondence to facilitate communication and enhance public service by Social Security Administration.
  • Entered data into system and updated claimant records and applications to keep records current.
  • Answered multi-line phone system and greeted callers enthusiastically.
  • Interviewed and adjudicated all initial and post adjudicated medicare claims, inquiries, billings and payments. Problem solved all issues when insurance terminated in error.
  • Scheduled appointments and conducted follow-up calls to claimants.
  • Managed mail and both incoming and outgoing correspondence, mail, email and faxes.
  • Greeted arriving visitors, determined nature and purpose of visit and directed individuals to appropriate destinations when issues could not be address within timeframe allotted by management for reception window.
  • Assisted public in filing reconsideration appeals, determining appeal decision based on Social Security laws.
  • Assisted public in filing hearings with administrative law judge. Follow up and processed hearing request to completion.
  • Volunteered to help with special projects of varying degrees of complexity.
  • Answered high volume of phone calls and email inquiries.
  • Handled incoming and outgoing mail, email and faxes.
  • Interviewed public to verify information and obtain additional details to enable correct processing of claims and ensure all earnings and personal information is correct on Social Security records..

Service Representative

Social Security Administration
Brooklyn, New York
10.1990 - 09.1995
  • Maintained productivity and quality standards at all times.
  • Scheduled appointment to resolve more complex issues.
  • Responded to customer concerns with friendly and knowledgeable service and remedied issues promptly and effectively.
  • Maintained accurate and current claimant account data with manual forms processing and digital information updates.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Adhered to government policies and scripts to consistently achieve call-time and quality standards.
  • Researched issues through identification of similar past problems and recommended most appropriate solution.
  • Achieved high satisfaction rating through proactive one-call resolutions of claimant issues.
  • Operated in dynamic, high-volume environments to provide skilled assistance large number of public each day.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Answered over 100 calls per shift to meet fast-paced office demands.
  • Performed various clerical duties by filing and faxing documents and creating customer databases.
  • Sought ways to improve processes and services provided.
  • Quickly and accurately answered client questions, suggested effective solutions and resolved issues to increase public satisfaction .
  • Communicated professionally with colleagues and clients.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Assisted customers with setting future appointments ,
  • Responded proactively and positively to rapid change.
  • Trained new personnel regarding government operations, policies and services.
  • Investigated and resolved claimant inquiries and complaints quickly.
  • Maintained up-to-date knowledge of Social Security law changes.
  • Provided ongoing public service.
  • Followed up with claimants about resolved issues to maintain high standards of customer service.
  • Chosen by management to provide answers and information regarding Social Security and Medicare inquires at public fairs, church groups and nursing homes.

CLAIMS DEVELOPENT CLERK

Social Security Administration, SSA
Brooklyn, New York
10.1985 - 10.1990
  • Followed up with claimants on unresolved issues.
  • Evaluated accuracy and quality of data entered into computer system and claimant files.
  • Established positive and trusting relationships with claimants, administering efficient customer service.
  • Analyzed information gathered to report findings and recommendations to appropriate Claims Representative.
  • Handled claim forms or related documents and reviewed for completeness.
  • Reviewed outstanding and redirected workloads to complete claims issues on time.
  • Verified claimant information by analyzing existing evidence on file.
  • Entered data into system and updated claimant contacts with information to keep records current.
  • Answered multi-line phone system and greeted callers enthusiastically.
  • Scheduled appointments and conducted follow-up calls to clients.
  • Provided clerical support to fellow employees by copying, faxing and filing documents.
  • Answered and routed incoming calls and took messages when personnel were unavailable.
  • Reviewed records and paperwork for errors and resolved issues with minimal direction.
  • Interacted with public on phone and at reception desk to answer questions and resolve issues without having to transfer to Claims Representative or Service Representative.
  • Established positive and trusting relationships with claimants, administering efficient customer service.
  • Carried out administrative tasks by communicating with claimants, distributing mail and scanning documents.
  • Maintained confidentiality of claimant finances, records and health statuses.
  • Generated, posted and attached information to claim files.
  • Answered central telephone system and directed calls accordingly.
  • Managed multiple tasks and met time-sensitive deadlines.
  • Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
  • Managed multi-line phone system directing individuals to desired personnel and providing general information about operations.
  • Answered large volume of incoming calls daily to resolve customer issues and schedule appointments.
  • Sorted, received and distributed mail correspondence between departments and personnel.
  • Triaged incoming calls on multi-line phone system and directed to departments based on customer needs.
  • Corresponded with clients through email, telephone or postal mail.
  • Responded to inquiries from callers seeking information.
  • Resolved customer issues quickly and notified supervisor immediately when problems escalated.
  • Confirmed appointments, communicated with clients and updated client records.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Answered constant flow of customer calls with minimal wait times.
  • Trained new personnel regarding company operations, policies and services.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Maintained up-to-date knowledge of product and service changes.

Bank Teller

CROSSLAND SAVINGS
Brooklyn, New York
07.1985 - 10.1985
  • Assisted customers with setting up or closing accounts, completing loan applications and signing up for new services.
  • Answered customer inquiries regarding account balances, transaction history, services charges and interest rates.
  • Built and strengthened customer relationships by leveraging excellent interpersonal and communication skills.
  • Counted and packaged currency and coins.
  • Removed mutilated currency from circulation.
  • Turned in excess cash to maintain drawer security.
  • Reconciled cash drawer and resolved discrepancies.
  • Placed orders for customer checks and verified starting numbers.
  • Completed highly accurate, high-volume money counts via both manual and machine-driven approaches.
  • Processed customer transactions promptly, minimizing wait times.
  • Logged cashier's checks and other transactions to maintain accurate account records.

Education

High School Diploma -

James Madison High School
Brooklyn, NY
06.1985

Skills

  • Coverage assessments
  • Documentation review
  • Settlement determinations
  • Collaborative relationships
  • Reporting skills
  • Data integrity
  • Excellent administrative abilities
  • Documentation abilities
  • Account management
  • Basic Math
  • Professional claimant contact
  • Dependable and Responsible
  • Active Listening
  • Collaboration
  • Data Management
  • Analytical and Critical Thinking
  • Benefits review
  • Claims
  • Microsoft Word
  • Building Customer Trust and Loyalty
  • Responding to Difficult Customers
  • Multitasking and Prioritization
  • Customer Data Confidentiality
  • Customer Account Management
  • Creative Problem Solving
  • Verbal and Written Communication
  • Upbeat and Positive Personality
  • Understanding Customer Needs
  • Issue and Complaint Resolution
  • Data Entry and Maintenance
  • Calm and Professional Under Pressure
  • Courteous with Strong Service Mindset
  • De-escalation Techniques
  • Efficient and Detail-Oriented
  • Strong Analytical and Problem Solving Skills
  • Multi-Line Phone Systems
  • Patient and Empathetic
  • Excellent Attention to Detail
  • Inbound and Outbound Calling
  • Document and Records Management
  • Time Management
  • Inventory Management
  • Administrative and Office Support
  • Regulatory Compliance

Accomplishments

- MULTIPLE EMPLOYEE AWARDS FOR EXCELLANT WORK ETHICS,

- MULTIPLE CORRESPONDENCE FROM THE PUBLIC WHOM IVE ASSITED INDICATING HOW MUCH I WENT ABOVE AND BEYOND TO ASSIST THEM AND THE KINDNESS SHOWN.

Timeline

Claims Representative

Social Security Administration
09.1995 - 01.2022

Service Representative

Social Security Administration
10.1990 - 09.1995

CLAIMS DEVELOPENT CLERK

Social Security Administration, SSA
10.1985 - 10.1990

Bank Teller

CROSSLAND SAVINGS
07.1985 - 10.1985

High School Diploma -

James Madison High School
ESTHER M. APONTE