Arikka Muhijuka
Carrollton,TX
Summary
Insurance industry professional experienced in marketing and sales of multiple lines of insurance and insurance claims services. Energetic and enthusiastic with demonstrated success in fast-paced and deadline driven environments. Collects and analyzes data, provide cost-effective solutions and meet the needs of clients by recommending suitable insurance products to provide financial security. Proven expertise in insurance products, service and customer needs. Familiar with analyzing documentation, liaising between parties and handling both routine and complex issues each day. Identifies and resolves concerns while promoting new products and meeting sales objectives. I am goal-oriented. Effective at dealing with individuals during stressful and confusing situations to address benefits needs and navigate agency structures. Practiced at working with regulatory limits and department standards to handle requirements via email, letter, telephone calls and in person. Offering 10-year background generating new business by selling various insurance plans.
Overview
13
13
years of professional experience
Work History
Technical Claims Support Representative
Cardinal Health PfizerL
Lewisville, TX
05.2016 - Current
- Investigated and evaluated workers' compensation claims to determine eligibility, coverage and appropriate benefits.
- Processed and reviewed documents related to workers' compensation claims such as medical reports, wage statements, job descriptions and incident reports.
- Resolved discrepancies in claim information by obtaining additional documentation or clarifying facts.
- Maintained accurate records of all claims including status updates, payment histories and other pertinent information.
- Interpreted state regulations regarding workers' compensation insurance coverage for employers.
- Assessed claimants' needs for vocational rehabilitation services and referred them to appropriate service providers when necessary.
- Advised claimants about the filing process for their workers' compensation claim.
- Provided guidance to employers on how to complete required forms accurately and completely.
- Reviewed court decisions affecting workers' compensation laws to ensure compliance with current regulations.
- Collaborated with legal counsel on cases involving disputed or denied claims.
- Conducted interviews with claimants, witnesses, employers and healthcare professionals as part of the investigation process.
Client Management Processor/Hazard Claims Processor
MSI
05.2015 - 05.2016
- Process incoming mail pertaining to the hazard insurance claims within established timelines
- Track hazard insurance claim auto-endorsements
- Obtain and review hazard insurance claim documents for accuracy
- This may include, but is not limited to: hazard insurance affidavits, adjuster's estimates, invoices, receipts, contractor's license/insurance and form W-9
- Process disbursement requests in an accurate and timely manner in accordance with both MSI procedure and investor guidelines
- Order inspections and appraisals timely to avoid delays in repairs or rebuilding of structure
- Maintain a working knowledge of investor guidelines and changes to reduce risk to the bank group involving hazard insurance claims
- Manage the incoming volume of hazard insurance claims efficiently while ensuring every pending claim is reviewed and followed up on per established requirements
- Actively work every pending hazard insurance claims to expedite the repair process to the satisfaction of MSI, the homeowner and contractor
- Research items and follow-up with customers in a timely manner
- This may involve working closely with other bank associates, other mortgage associates, or third parties (insurance agents, claim adjusters, contractors, etc.) to obtain the necessary information.
Insurance/CSR, Sales
Humana
Irving, TX
02.2011 - 05.2015
- Insurance/Customer Service Rep Assisted customers with paying on their bills/past due bills Filed invoices.
- Reviewed customer insurance claims to ensure accuracy and completeness of information.
- Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims.
- Assisted customers in filing new insurance claims and provided status updates on existing ones.
- Took payments over the phone CC/CHECKING ACC.
- Updated customer files with current account information. Successfully handled all relations issues.
- Assisted in the training of new customer representative and associates.
- Generated repeat business through successful client follow-up. Took inbound calls/outbound calls.
- Gave customer info on medicines.
- Gave customers their deductible.
- Help customers know what type of insurance they had.
- Handled customer inquiries and complaints in a timely manner.
- Provided customer service support to customers over the phone and by email.
- Identified customer needs and provided appropriate solutions.
- Researched required information using available resources.
- Followed up with customers to ensure their satisfaction.
- Maintained records of customer interactions, transactions, comments, and complaints.
- Assisted in the development of customer service procedures and policies.
- Performed account maintenance activities such as updating client information in databases.
- Collaborated with other teams within the organization to resolve complex issues related to customers' accounts.
- Calculated benefit payments based on policy terms, coverage limits, and applicable regulations.
- Ensured compliance with state laws governing insurance practices as well as company policies and procedures.
Education
Bachelor's Degree - Business Management
Texas Southern University
05-2010
High School Graduate -
W.T White High School
01-2005
Skills
- Stacked organizational habits
- Excellent service
- Interpersonal skills
- Professional phone skill sets
- Self-motivated
- Detail-oriented
- Team environment
- Outstanding problem-solving
- Conflict resolution
- Leadership qualities
- Team lead
- Creative
- Effective problem-solving
- Proficient with Word
- Excel
- Outlook
- Quick learner
- Adaptability
- Assisting co-workers
- Training and guiding
- Work ethic
- Top-ranked performance
- Computer savvy
- Tech-savvy
- IT expertise
- Preparing reports
- Management Support
- Data Entry
- Workplace Safety
- Program Support
- Production Support
- MS Office
- Performance Evaluations
- Performance Improvement
- Claims Investigation
- Claims Processing
- Microsoft Office
- Insurance knowledge
- Policy Interpretation
- Coverage Determination
- Closing Techniques
- Sales analytics
- Relationship selling
- Networking
- Sales management
- Territory Management
- Up-selling
- Prospecting skills
- Sales strategy development
- Business Development
Timeline
Technical Claims Support Representative
Cardinal Health PfizerL
05.2016 - Current
Client Management Processor/Hazard Claims Processor
MSI
05.2015 - 05.2016
Insurance/CSR, Sales
Humana
02.2011 - 05.2015
Bachelor's Degree - Business Management
Texas Southern University
High School Graduate -
W.T White High School