Hi, I’m
Crystal Vega
Freeland,United States
Summary
High-performing Claims Examiner with a deep knowledge in the Claims Industry, Customer Service Industry, and Property Management Industry. Strong devotion for Public Service, while obtaining seven years experience building positive relations, data gathering, and problem solving. Confident in ability to collaborate with cross-functional teams to solve complex issues. Committed to continuous improvement and contributing to team success.
Overview
9
years of professional experience
1
Certification
Work History
Commonwealth Of Pennsylvania - Department Of Labor
Claims Examiner
05.2022 - 11.2022
Job overview
- Gathered pertinent information regarding claims for unemployment compensation benefits and makes determinations of applicant’s eligibility for benefits.
- Conducted fact finding in cases of disputed claims by conferring with claimants and employers to gather pertinent data and issues decisions based on analysis of facts to deny of award benefits.
- Identified and investigated cases of overpayments of benefits and arranges for recovery of monies from claimants.
- Processed and reviewed appeals in disputed claims by claimants or employers and explained their rights and responsibilities under Pennsylvania Unemployment Compensation Law.
- Represented Office of UC Service Centers before Appeals Referees and UC Board of Review.
- In cases of prosecution of claimants for UC fraud, provided technical analysis of facts regarding cases and represented Office of UC Service Centers in testimony before magistrates.
- Conducted correspondence with claimants, employers and other parties concerned with cases of claims for unemployment compensation benefits.
- Ensured timely processing and payment of claims for unemployment compensation in accordance with established standards.
- Prepared and maintained pertinent claims information on official forms and maintains records of claims activities conducted by UC Service Center.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Maintained weekly quota of 75 determinations or more.
- Surpassed BTQ and Quality Assurance reviews.
Commonwealth Of Pennsylvania - Department Of Labor
Claims Interviewer
10.2020 - 05.2022
Job overview
- Conducted interviews with participants to assess eligibility for unemployment claims by telephone and/or in person.
- Operated PC and multiple programs to enter and retrieve data, modify records, process claims, and to build UC claim, identify any issues affecting eligibility of claimants for benefits.
- Adapted interview style to suit needs of position and candidate.
- Conducted initial fact-finding with claimant and identifies both monetary and non-monetary issues that may affect claimant’s eligibility for benefits and takes necessary action to refer claims to either monetary or adjudication units.
- Assisted in coordination of on-site interviews, managing schedule to stay organized.
- Collaborated with other HR team members to develop more comprehensive and successful interview processes.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained accurate and up-to-date records of claim information for future reference.
- Identified pending payments and evaluated if payment is eligible for release or additional action needed before issuing payments.
- Reviewed forms submitted by claimants, employers and agent offices to ensure all necessary data is provided.
- Completed 30 case loads daily by phone, email, and chat.
- Investigated candidate history and employment claims to confirm eligibility for positions
Carmen Santiago
Onsite Property Manager
01.2014 - 03.2016
Job overview
- Communicated effectively with owners, residents, and on-site associates.
- Collected and maintained careful records of rental payments and payment dates.
- Conducted regular inspections of both interior and exterior of properties for damage.
- Kept properties in compliance with local, state and federal regulations.
- Implemented and enforced policies and procedures to maintain properties to highest standards.
- Monitored and tracked payments and expenses, providing timely and accurate financial reports.
- Coordinated appointments to show marketed properties.
- Delivered emergency 24-hour on-call service for tenants on building issues.
Education
Health Opportunities HS, Bronx, New York
High School Diploma
2005
Skills
- Data Verification
- Reservation Documentation
- Deductible Collection
- Claims Understanding
- Customer Relations
- Relationship Building
- Health & Safety Training
- Data Gathering
- Benefits Review
- Interview Claimants
- Onsite Evaluation
- Authorize Payments
Certification
Customer Relations, Problem Solving, Relationship Building, Health & Safety Training.
Research Skills: Data Gathering, Data Analysis, Report Generation.
Timeline
Claims Examiner
Commonwealth Of Pennsylvania - Department Of Labor
05.2022 - 11.2022
Claims Interviewer
Commonwealth Of Pennsylvania - Department Of Labor
10.2020 - 05.2022
Onsite Property Manager
Carmen Santiago
01.2014 - 03.2016
Health Opportunities HS
High School Diploma
Customer Relations, Problem Solving, Relationship Building, Health & Safety Training.
Research Skills: Data Gathering, Data Analysis, Report Generation.
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