Beverly Hinds
Plantation,FL
Summary
Years of experience in administrative duties, including leadership, mentoring, training, management, and interpersonal skills. A goal-driven professional who excels in communication and teamwork environments, consistently providing full-scale administrative, customer, and multi-tasking services. Strong experience in claims adjudication (professional and facility), provider contracting, and customer relations, with a solid ability to demonstrate successful accomplishments in quality assurance.
Overview
27
27
years of professional experience
Work History
CUSTOMER SERVICE REPRESENTATIVE
ROAD READY INSURANCE
01.2022 - Current
- Field and screen new leads while gathering detailed information about the client’s needs.
- Provide detailed information to the insured, agents, brokers, and all clients regarding policies and coverage.
- Review agency application and quotes for accuracy prior to binding.
- Upload policies and client’s information into the agency management system (Applied Epic)
- Process renewals, endorsements, cancellations, and reinstatements independently and in conjunction with producers.
- Manage and generate certificates of insurance, auto ID card, generate MVR’s, submit quotes timely and efficiently.
- Manage and execute billing activities, and payments by way of credit card or ACH wires.
- Review assigned claims, contact the insured and other affected parties, initiate documentation in the claim handling system.
- Conduct interviews, gather evidence, take affidavits, and produce comprehensive claim reports.
- Document claims and accurately update claim logs, keep insured and claimant updated on claims process.
- Complete coverage analysis, review policy coverages, provisions, endorsements, and the significance of the reported loss.
- Ensure policyholder benefits are identified, create sub-claims if needed and refer claims to the appropriate claim handler.
- Influence membership growth and retention; communicate effectively with client.
- Build and maintain positive relationships with internal and external clients to foster growth
REVENUE SPECIALIST III
STATE OF FLORIDA–DOR
01.2014 - 01.2022
- Respond to customers’ inquiries professionally, timely, and accurate manner while consistently meeting all guidelines.
- Educate customers on the eligibility of services and enrollment process for state Medicaid and CHIP related to child support.
- Research and refer customers to available state-assisted programs.
- Analyzed financial activities to reconcile child support payments and verify account accuracy in the State's system.
- Negotiate with parents to facilitate child support payments.
- Research and conduct proactive investigations and negotiate a successful resolution of discrepancies effectively.
- Responsible for conducting interviews, gathering evidence, taking affidavits, interpreting statutes and rules
- Interacts with other governmental agencies and personnel to secure and share regulatory information.
- Update file cases according to Federal, State and Department procedures and rules.
- Maintain proper usage of state-issued equipment to ensure confidentiality of sensitive information.
- Ability to work independently in a fast-paced environment, meet deadlines, and manage changes effectively.
OFFICE MANAGER
SASEI TRUCKING
01.2008 - 01.2014
- Responsible for maintaining and enforcing compliance with licenses, certification, and DOT standards.
- Maintain the integrity of the company by enforcing compliance with federal and state regulations and company policies.
- Researched and prepared information to assist with designing and implementing a training plan.
- Order and review MVRs for pre-employment, DOT compliance and insurance risk Management.
- Conduct reference checks and scheduled drivers for interviews and DOT drug screening.
- Prepare reports by collecting, analyzing, and summarizing information.
- Initiated contract, negotiated shipping rates with trucking and warehousing companies.
- Acted as a third-party intermediary between customers and other trucking companies in claims dispute proceedings.
- Review, investigate and make recommendations on cargo, and liability claims.
- Communicated the importance of claims prevention and on-time pickups and deliveries.
- Maintain a professional level of confidentiality and safeguard customers' information.
GRIEVANCE AND APPEAL SPECIALIST
HIP ADMINISTRATOR
01.1999 - 01.2007
- Analyzes complaints, grievances and appeals from insureds, providers and facilities and other entities.
- Professionally prepared cases containing the required documentation.
- Interacts with other governmental agencies and personnel to secure and share regulatory information.
- Review insurance contracts, forms, endorsements, and claims forms for adjusting practices and activities
- Research, analyze and resolve claims issues/process facility and professional claims as needed.
- Ensures legal compliance by following company policies, procedures, guidelines, and State and Federal regulations.
- Solid knowledge and understanding of Manage care industry and provider payment methodologies.
- Refer claims to other company units when necessary (Underwriting, Recovery Units, or Claims Special Investigation Unit.
- Document medical claims actions by completing forms, reports, logs, and records.
- Maintain work files and provides comprehensive written reports of investigative findings.
Education
B.S.M. – Bachelor of Science - Management
University of Phoenix
Plantation, FLM.S.A – Master of Health Administration - undefined
University of Phoenix
Plantation, FLLICENSE - Florida 440 Customer Service Representative
Florida Insurance College
Skills
- Analysis/Critical Thinking
- Customer Service
- Health Insurance Admin
- Scheduling and Organization
- Training and Leadership
- Supervision and Management
- Proficient computer and keyboarding skills
CUST
- Key areas of expertise:
- Proven track record of over ten years of success in meeting and obtaining goals, providing invaluable expertise.
- Creative, flexible, innovative, regularly providing full-scale services to foster growth and success in a fast-paced, team-oriented environment
Timeline
CUSTOMER SERVICE REPRESENTATIVE
ROAD READY INSURANCE
01.2022 - Current
REVENUE SPECIALIST III
STATE OF FLORIDA–DOR
01.2014 - 01.2022
OFFICE MANAGER
SASEI TRUCKING
01.2008 - 01.2014
GRIEVANCE AND APPEAL SPECIALIST
HIP ADMINISTRATOR
01.1999 - 01.2007
B.S.M. – Bachelor of Science - Management
University of Phoenix
M.S.A – Master of Health Administration - undefined
University of Phoenix
LICENSE - Florida 440 Customer Service Representative
Florida Insurance College
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