Denise Welch
Twin Falls,ID
Summary
Passionate about promoting lasting customer satisfaction by delivering quality service and unparalleled support. Proficient in customer service best practices and related options. Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty. Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results. Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Knowledgeable and dedicated customer service professional with extensive experience in Social Insurance programs. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with the public. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Dedicated Social Insurance professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organization. Reliable employee seeking a customer service position or administrative assistance. Offering excellent communication and good judgment. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level or higher customer service or administrative position. Ready to help team achieve company goals. Experienced Claims Customer Service Specialist with over thirty-five years of experience in the insurance and customer service field. Excellent reputation for resolving problems and improving customer satisfaction.
Skilled Laborer with experience providing excellent service as part of licensed construction team. Familiar with safety regulations and occupational hazards. Safely operates equipment and remains focused on task completion. Focused Construction professional with strong command of industry-specific tools and equipment. Excellent history of supporting commercial and residential builds with zero incident safety record. Learning invaluable skills that will be used extensively in daily life. It was challenging and inspirational and helped build skills in a completely different industry. It was empowering and motivational to meet those challenges.
Overview
32
32
years of professional experience
Work History
Construction Laborer
S Sawtooth Remodeling, LLC
06.2021 - 11.2022
- Utilized hammers, saws, squares, levels and multiple other manual and electronic devices to complete projects.
- Worked independently in fast-paced environment while meeting productivity and quality expectations by passing all inspections and completing all jobs on schedule.
- Worked with more knowledgeable professionals to grow understanding of principles and construction standards.
- Demonstrated safe and proper operation of equipment and tools to prevent harm to team members.
- Prepared and cleaned surfaces for rebuilding purposes by removing damaged tiles, bricks and mortar.
- Collected measurements and marked locations as part of project preparations.
- Prepared job sites for work plans by measuring and marking different distances.
- Learned various skills such as installing drywall, insulation, Durock for stone, placing of stone, mudding, taping, texturing, weather stripping, and painting.
Claims Specialist Technical Expert
Social Security Administration
Twin Falls, ID
06.2000 - 02.2021
- Technical expert t responsibilities included developing, adjudicated and authorized to completion more complex, non-routine cases, typically those that were highly unusual, without precedent and usually involving different Social Security Administration (SSA) administered programs, such as Retirement, Disability and Supplemental Security Income (SSI). As well as post-entitlement actions including overpayments, disability work reviews, disability medical reviews, representative payee applications and fraud reviews.
- Provided lead role in technical training (classroom, one-to-one, initial, in-service, refresher, remedial), coaching and mentoring other employees, providing focal point in office for definitive interpretation of new legislation, regulation, policies, procedures and/or updates. Identified training needs and conducted training with management concurrence. Also, provided training for technical mentoring to employees in other organizational components as needed.
- Provided expert technical advice and assistance to other employees during decision-making process. Used expert technical knowledge of guidelines and policies to assist other employees with complex case processing and post-entitlement actions to ensure accuracy of information and decisions. Coached employees in interviewing and other developmental techniques to gather necessary information that resulted in high volume and quality case processing. Developed and responded to high profile or time sensitive case processing. While working at Field Office (FO) in Twin Falls, Idaho, we ranked best office in our region for many years.
- Served as liaison with employers, payee organizations, congressional offices and other state/local entities to resolve complex cases or to explain agency policy in such cases. Served as technical expert to these organizations.
- Conducted case reviews for quality improvement, training and performance management and as necessary performed audit interviews. Provided feedback to management on process improvements and prepared written instructions, feedback and document processes for improvement as appropriate.
- Provided technical expertise on most effective use of new and existing software/systems to process specific complex claims and post-entitlement actions. Assisted, guided and trained technicians in appropriate application of claims and post-entitlement systems. Policies and procedures were constantly changing, so instruction was needed to instruct accordingly. Fostered use of internet, intranet and various software applications. Encouraged use of developmental tools issued by agency to aid technicians in doing their jobs. Assisted in resolving most complex programs/technical/systems issues with Regional Office (RO) program staff, Disability Determination Services (DDS), Program Service Centers (PSC), Foreign Service Posts (FSP), Teleservice Centers (TSC), Workload Service Centers (WSC), Workload Support Units (WSU), Office of Central Operations (OCO) and its Processing Centers (PCs) and Office of Disability Veterans' benefits, immigration, nationality and other having relationships with SSA programs, to facilitate proper and timely decisions on complex cases.
- Knowledge of agency's strategic goals as well as comprehensive knowledge of national and regional program objectives, policies, procedures, organizations and processes of programs with which SSA is interrelated sufficiently to devise new or revised approaches to issues not resolved by use of existing guidance.
- Ability to maintain flexibility and approachability to handle many responsibilities in assisting co-workers and management while maintaining my own balanced workload.
- Ability to conduct business in professional and courteous manner with both public and co-workers; and to support unit efforts to achieve positive and productive work environments in order to meet agency goals and missions. Customer service was always number one priority as well increasing morale of co-workers.
- Guidelines required for job, included, being up to date on national and regional laws, regulations, policies, precedent decisions and management decisions, as well as general administrative policies. Existing policies or guides were often incomplete, contradictory, of limited use or inadequate, requiring development of modified or new policies and operating instructions. Initiative, innovation and resourcefulness were required to determine actions needed to be taken on highly complex and/or sensitive cases, devising new approaches to extend existing policy or procedure to new areas or making recommendations based on inadequate, incomplete or non-existent policy. I had to study program operations, new legislation, automated systems, management initiatives and operation of interacting programs and organizations to develop new and modified operating instructions and training material.
- Served as technical expert on public fraud issues in certain claims and post-entitlement cases. Developed potential cases, and when claimant misinterpreted his/her circumstances, was required to send to SSA's Office of Inspector General (OIG) to adjudicate case. Collected all relevant information and background on case and then developed basis of fraud committed and recommendation on further action. Worked with OIG to provide technical development of most sensitive and highly complex cases.
- Ensured that integrity of programs administered by SSA were maintained and protected. Properly safeguarded personally identifiable information (PII) from loss, theft or improper disclosure including inadvertent disclosure and then properly reported to manager on any breach or loss of PII in any form.
- Functioned as technical resource to support and coordinate new, highly sensitive workloads and processes or programmatic pilots on ad hoc basis.
- Performed full range of Claims Specialist duties for all programs administered by SSA.
- Knowledge required by position included: comprehensive knowledge of all provisions administered under SSA and how it interfaced with other related programs to effectively deliver excellent service to public we served.
- Comprehensive knowledge of automated programs and systems in delivery of services in order to maintain efficiency in work processing and assisting and mentoring of other staff.
- Expert knowledge of SSA programs in order to solve most complex and sensitive cases, to mentor and advise other specialists on case processing, diagnosing fraud, systems and processing problems, and to make recommendations on new, emerging or quality issues.
- Thorough knowledge of assigned organizations, its processes, structure, workflows and routines to analyze problems, new initiatives and systems to streamline business services.
- Knowledge of State laws involving social service programs, workers' compensation, inheritance/relationship issues and various Federal laws relating to tax code and railroad retirement. complexity of job entailed analyzing numerous programmatic work processes related to designing and connecting quality assurance reviews, providing technical leadership both to individuals and lead coordinated capacity to meet organizational projects and pilots and to advise in processing more complex or controversial case situations, where little or no precedent exists. Decisions included assessing unusual circumstances, variation in approach, and resolving incomplete or conflicting information. I was required to consider and evaluate numerous interrelated facts and conditions with technical, legal and organizational complexities, security considerations, unusual combination of issues and need to devise and implement new or revised processing techniques. Work called for innovative approaches to resolve unique or unusual issues, and to assist other employees in such casework as well as experienced judgement to render sound recommendations and decisions to ensure increased operating effectiveness.
Claims Specialist
Social Security Administration
04.1990 - 08.2000
- As Claims Specialist, it required to providing services to public on daily basis. Job duties included taking applications for Retirement, Disability, Medicare, Medicare subsidies and Survivor benefits. It also included post-entitlement actions such as Disability medical reviews, Disability work reviews, overpayments and Representative payee applications.
- Followed up with customers on unresolved issues.
- Determined appropriateness of payees to protect claimants and their Social Security (SS) benefits.
- Reviewed files to determine current status of Disability conditions, conducting work reviews and medical reviews, as needed, and then develop plan of action.
- Escalated files to Office of Inspector General (OIG) if fraud allegation was made. It required full development of issues and recommendations for action.
- Position was combined, so, we were required to perform duties as Service Representative (SR) which entailed performing all services in Field Office (FO) provided. This included working front reception desk on rotating basis which required direct contact with public. World class service was expected. I was required to analyze situations, promptly, and immediately assess necessary action. We served from 100 to 200 customers daily. We had opportunity to provide service to public; people already receiving SS benefits and people filing for benefits for first time. We also served those living in foreign countries who were receiving SS benefits.
- Position required investigating and making decisions regarding approval or denial of claims for SS and Supplemental Security Income (SSI). Contact was made in person and over phone. I had training specifically tailored to serving public and knowing SS and state laws.
- This position required establishing benefits for all programs SS administered. I was required to obtain, clarify and verify information which was used to analyze claims and make decisions regarding entitlement to benefits.
Education
Bachelor of Science - Psychology
College of Idaho
Caldwell, ID05.1989
Bachelor of Arts - Sports
College of Idaho
Caldwell, IDSkills
- Responding to Difficult Customers
- Following Supervisor Instructions
- Call Documentation
- Building Customer Trust and Loyalty
- Data Entry and Maintenance
- Efficient and Detail-Oriented
- Needs Assessment
- Calm and Professional Under Pressure
- Understanding Customer Needs
- Customer Account Management
- Interpretation of Laws and Regulations
- Protecting Personal Identifiable Information (PII)
- Report Creation
- Inquiry Requests
- Answering Customer Questions
- Inbound and Outbound Calling
- Customer Inquiry Response
- Microsoft Exchange
- Telephone Management
- Information Inputting
- Electronic Information Systems
- Document Conversion
- Call Transfers
- Report Preparation
- Correcting Discrepancies
- Customer Service and Assistance
- Proactive Self-Starter
- Technical Support for Management, Employees and Public
- Microsoft PowerPoint
- Critical Thinking
- Answering Emails
- Complaint Response
- Recommending Solutions
- Computer Proficiency
- Establishing and Maintaining Customer Relationships
- Call Volume and Quality Metrics
- Cultural Awareness
- Directing Calls
- Team-Oriented and Cooperative
- Complex Knowledge of Programs Administered by Agency
- Excellent Attention to Detail
- Document and Records Management
- Patient and Empathetic
- Corrective Actions
- Policy and Procedure Adherence
- Solving Customer Concerns
- Administrative and Office Support
- Customer Information Databases
- Skilled in Microsoft Office
- Skilled in Various Intranet and Software Programs
Timeline
Construction Laborer
S Sawtooth Remodeling, LLC
06.2021 - 11.2022
Claims Specialist Technical Expert
Social Security Administration
06.2000 - 02.2021
Claims Specialist
Social Security Administration
04.1990 - 08.2000
Bachelor of Science - Psychology
College of Idaho
Bachelor of Arts - Sports
College of Idaho
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