DEMETRIA ROMERO
Casa Grande,AZ
Summary
Highly skilled and detail-oriented insurance representative with a license to sell property and casualty insurance currently employed with a well-run organization seeking a position offering new challenges, career growth and advancement.
Very knowledgeable and have been in the insurance industry for over 2 years and in the billing and customer service field for more than 8 years in many different settings. Experienced in working in a fast pace environment using multiple internet programs and am highly efficient in functioning multiple Microsoft programs.
Exceeds at meeting deadlines and goals and often praised for being engaging, personable and professional under pressure and a major contributor to team based environments.
Overview
15
15
years of professional experience
Work History
Sr. Claims Adjuster
USAA
04.2022 - Current
- Managed high call volume while maintaining professionalism, empathy, and attention to detail in each interaction.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Identified suspicious losses and contacted manager for investigative assistance.
- Documented information gathered in field and uploaded data to company database for efficient processing using Guidewire.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Followed up with insured individuals regarding premium and deductibles payments.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Enhanced customer satisfaction by promptly addressing and resolving complex claim issues through thorough investigation and analysis.
- Optimized workload management, prioritizing time-sensitive cases to ensure timely resolutions for clients.
Customer Service Representative I
American Family Insurance
11.2015 - 04.2022
- Responded to customer calls swiftly to resolve issues and answer questions.
- Implemented strategies to optimize cross-selling opportunities among existing customers, driving revenue growth.
- Participated in ongoing professional development courses to maintain current knowledge of insurance products and regulations, enhancing overall expertise as a representative.
- Kept detailed records on individual insurance claims and incorporated into detailed client files.
- Contacted underwriter and submitted appropriate forms to obtain binder coverage.
- Researched and resolved billing discrepancies to enable accurate billing.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
Pharmaceutical Customer Service Representative
Philidor Rx Services
03.2014 - 07.2015
- Assisted pharmacist by filling prescriptions for customers and responding to patient questions regarding prescription and medication-specific issues.
- Answered telephones and provided information about order status, store hours and pharmacy procedures.
- Facilitated effective communication between team members, fostering a collaborative work environment within the pharmacy.
- Enhanced customer satisfaction by providing efficient and accurate prescription filling services.
- Supported operations with filing, copying and faxing.
- Improved operational efficiency by assisting with routine administrative tasks such as filing, data entry, and report generation.
- Verified order information against computer database.
- Collaborated with healthcare professionals to provide seamless patient care, addressing inquiries regarding medications and dosages.
- Completed regulatory compliance tasks, such as logging controlled substances, upholding legal requirements in pharmaceutical practices.
Financial Advisor
Perceptis
04.2012 - 02.2014
- Financial advisor for Maricopa Colleges Take inbound calls from college students inquiring on how to receive financial aid
- Provide financial eligibility information
- Notify students of what documents are required to receive financial aid
- Schedule appointments for students to meet with financial advisors
- Research missing documentation
- Document each transaction accordingly.
Accounting Clerk/collections Agent
NCO Financial Systems
10.2010 - 02.2012
- Inbound/outbound calls to clients to inform about lawful matters
- Notify customers of tickets and warrants out for their arrests
- Accept payment arrangements
- Take payment over phone
- Make courtesy call for payment arrangement and to notify customers when their accounts go into collections
- Notate each account individually.
- Maintained organized filing systems for accounting records, ensuring easy access to crucial financial information when needed.
- Processed payments and documents such as invoices, journal vouchers, employee reimbursements, and statements.
- Achieved successful debt collection results by utilizing negotiation skills and developing customized payment plans.
- Negotiated to collect balance in full.
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Processed credit card payments and reconciled credit card statements for accuracy in accounting process.
- Managed past due collection calls, skip tracing, outside collections agency coordination and litigation activities.
Customer Service Rep
CVS CareMark
12.2009 - 07.2010
- Optimized workflow processes to reduce wait times and improve overall customer experience in the pharmacy.
- Provided exceptional customer service by addressing inquiries and concerns in a timely manner, resulting in increased loyalty and trust from clients.
- Handled sensitive patient information confidentially, ensuring compliance with HIPAA guidelines.
- Resolved insurance claim issues promptly, facilitating seamless coverage for patients'' medications.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
Education
Bachelor Of Science - Clinical Psychology
Maricopa Community Colleges - Glendale Community College
Glendale, AZ2025
Diploma -
Maricopa County Home Schooling
Phoenix, AZ01.2011
Skills
- Professionalism and Integrity
- Team Leadership Qualities
- Computer Software Proficiency
- Attention to Detail Focus
- Time management mastery
- Analytical Problem Solving
- Regulatory Compliance Knowledge
- Continuing Education Commitment
- Complex Case Management
- Policy Interpretation Accuracy
- Insurance policy coverage knowledge
- Advanced oral and written communication skills
- Regulatory Compliance
- Legal proceedings knowledge
Accomplishments
Licensed property and casualty insurance adjuster with years of experience in auto and medical insurance settings.
Timeline
Sr. Claims Adjuster
USAA
04.2022 - Current
Customer Service Representative I
American Family Insurance
11.2015 - 04.2022
Pharmaceutical Customer Service Representative
Philidor Rx Services
03.2014 - 07.2015
Financial Advisor
Perceptis
04.2012 - 02.2014
Accounting Clerk/collections Agent
NCO Financial Systems
10.2010 - 02.2012
Customer Service Rep
CVS CareMark
12.2009 - 07.2010
Bachelor Of Science - Clinical Psychology
Maricopa Community Colleges - Glendale Community College
Diploma -
Maricopa County Home Schooling