Summary
Overview
Work History
Education
Skills
Timeline
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Coraima Gonzalez

Charlotte,NC

Summary

Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements. Dedicated team player adept at managing customer service and claims processing for policyholders. Looking for a long-term position with a growth-oriented company.

Overview

9
9
years of professional experience

Work History

Claims Associate

Spectrum
Charlotte, NC
03.2022 - 07.2024
  • Investigated and appealed denied claims, and cleared up discrepancies by phone, fax, or email
  • Thoroughly reviewed and implanted understanding of Explanation of Benefits (EOBs)
  • Utilized payer websites & dedicated call centers for claim status and claim review
  • Researched claim facts for accuracy and request corrected claims as needed.
  • Provided feedback on payer trends and issues prohibiting payment to Lead/Manager and report issues and concerns regarding account resolution to avoid write offs.
  • Notated changes in account status on an ongoing basis in a clear and concise manner. Properly note activities detailing the steps taken to resolve outstanding balance.

Customer Service Representative

Verizon
Charlotte, NC
01.2018 - 08.2021
  • Enthusiastically responded to an average of 80 incoming calls daily, providing execellent customer support and effectively resolving customer issues
  • Escalated interactions when necessary and appropriate
  • Responded to requests for assistance and/or processing payments
  • Provided Feedback on call issues and Upsell if required
  • Identify customer needs, problem-solve concerns, and improve customer satisfaction
  • Maintained and updated customer information on a regular basis
  • responsibility included gathering thorough documentation and entering information into various systems.
  • Connected with customers via phone/email/chat to resolve their questions or concerns

Bartender

TopGolf
Charlotte, NC
06.2015 - 12.2017
  • Prepared alcoholic and non-alcoholic beverages according to recipe standards.
  • Adhered to state regulations regarding serving alcohol responsibly.
  • Managed cash drawer at the end of each shift ensuring accuracy of funds received.
  • Made friendly conversation with customers to provide enjoyable bar experience.
  • Managed accurate bar tabs and processed cash and credit card transactions.
  • Resolved customer complaints in a professional manner.

Education

High School Diploma -

E.E. Waddell High School
Charlotte, NC
06-2010

Skills

  • Excellent phone manners
  • Advanced Computer Skills
  • Strong Written and Verbal communication
  • Claims Investigation
  • Team Collaboration
  • Creative problem solver and quick thinker
  • Troubleshooting
  • Data Analysis
  • Conflict Resolution
  • Data Entry
  • Ability to type 35 wpm
  • Flexible Schedule

Timeline

Claims Associate

Spectrum
03.2022 - 07.2024

Customer Service Representative

Verizon
01.2018 - 08.2021

Bartender

TopGolf
06.2015 - 12.2017

High School Diploma -

E.E. Waddell High School

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Coraima Gonzalez