Derenique Burt
Anaheim,CA
Summary
Dedicated professional with a strong work ethic and effective communication skills. Demonstrates adaptability under pressure and excels in addressing customer concerns. Committed to enhancing organizational goals through proactive teamwork and exceptional service delivery. Focused on improving customer satisfaction and driving positive outcomes.
Overview
18
18
years of professional experience
Work History
Benefits/ Claims Respresentive
United Healthcare
Anaheim, California
01.2024 - Current
- Respond to member inquiries via phone, email, or chat regarding benefits, claims, coverage, and account information, ensuring a positive member experience.
- Uphold confidentiality and security of member information in accordance with HIPAA and company policies.
- Processed insurance claims with accuracy and attention to detail.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Verified claim data correctness in preparation for processing.
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Assisted with customer requests and answered questions to improve satisfaction.
- Escalated complex issues to management for resolution as needed.
- Advised clients on benefits options and enrollment processes.
- Managed client inquiries regarding claims and policy details.
- Reviewed and updated benefits materials for accuracy and clarity.
Intensive Case Manager
Amity Foundation
Los Angeles, California
09.2018 - 02.2021
- Coordinated comprehensive case management for clients with diverse needs.
- Developed individualized service plans in collaboration with multidisciplinary teams.
- Facilitated access to community resources and support services for clients.
- Conducted regular client assessments to monitor progress and adjust plans.
- Provided crisis intervention and conflict resolution to clients in distress.
- Maintained detailed documentation of client interactions and service delivery.
- Educated clients about available programs and resources for enhancement of well-being.
- Collaborated with external agencies to ensure holistic care for all clients.
- Engaged with community partners to build relationships that would benefit our organization's mission.
- Participated in weekly clinical supervision meetings with program director and supervisor regarding caseloads and any relevant updates on cases being managed by staff members.
- Assisted clients in developing strategies for managing symptoms associated with mental health disorders.
- Coordinated discharge planning activities for clients transitioning out of the program into more independent living arrangements.
- Attended court hearings on behalf of assigned clients when necessary; provided testimony related to the client's current condition or prognosis if applicable.
- Developed trusting relationships with social services, health care providers and governmental agencies.
- Provided referrals to appropriate medical, mental health, and social services.
- Identified barriers to client success and developed strategies to overcome them.
- Negotiated with insurance companies and other payers to secure coverage for client services.
- Conducted home visits to assess living conditions and support needs.
Retail Operations Supervisor
AT&T Mobility
Torrance, California
11.2014 - 09.2018
- Provided leadership and direction to staff members while fostering an atmosphere of teamwork.
- Developed and implemented operational strategies to increase customer satisfaction levels.
- Ensured prompt resolution of customers' inquiries via phone, email or chat support channels.
- Monitored staff performance to ensure adherence to customer service standards.
- Reviewed customer feedback and complaints to identify areas of improvement in customer service processes.
- Reviewed customer feedback surveys weekly in order to make necessary adjustments.
- Maintained inventory records to ensure accurate stock levels at all times.
- Analyzed sales data to identify areas of improvement in performance and profitability.
- Developed marketing campaigns that increased sales by 15%.
- Oversaw the training of new employees on company policies and procedures.
- Created and maintained a positive working environment for store associates.
- Maintained up-to-date knowledge of company products, services, pricing structures, promotions.
- Managed financial activities including budgeting, forecasting, payroll, accounts receivable and payable.
Emergency roadside service supervisor
Automobile Club of Southern California
Long Beach, CA
09.2013 - 11.2014
- Team Leadership- Supervise and coordinate the daily activities of roadside assistance technicians, ensuring timely and efficient service delivery.
- Dispatch Management- Oversee the dispatching of roadside assistance calls, prioritize service requests, and monitor technician progress to meet customer expectations.
- Customer Service Oversight- Ensure high-quality customer service by providing support, guidance, and problem resolution for members experiencing roadside emergencies.
- Tracked and analyzed team performance metrics, including response times, service quality, and customer satisfaction scores; provided targeted coaching and feedback to enhance team effectiveness.
- Training & Development- Conduct training sessions for new and existing team members on safety procedures, technical skills, customer service, and company policies.
- Problem Resolution- Handle escalated member issues or emergencies, providing prompt resolutions and maintaining member satisfaction.
- Reporting & Documentation- Maintain accurate records of service activities, technician schedules, and incident reports; prepare regular reports for management.
- Identified and implemented opportunities to improve service processes, aiming to reduce response times and enhance operational efficiency.
- Prepared and coordinated response plans for large-scale emergencies, ensuring readiness and effective management of service disruptions.
Customer Service Manager
T-Mobile
Torrance, California
06.2008 - 09.2013
- Compiled and analyzed customer feedback, complaints, and suggestions to inform management decision-making.
- Managed the development of a comprehensive knowledge base used by team members when responding to customers' queries.
- Partnered with senior management to develop strategies enhancing service quality across the organization.
- Upheld quality control policies and procedures to increase customer satisfaction.
- Fostered strong relationships with customers, managers, and team members to promote a collaborative work environment.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Maintained knowledge of company products and services to promptly resolve complaints and concerns.
- Maintained up-to-date knowledge of company products, services, pricing structures, promotions.
- Reviewed customer returns for accuracy and compliance with company policies.
- Organized shift assignments to meet expected coverage demands by factoring in typical loads and upcoming changes.
- Audited customer account information to identify issues and develop solutions.
Education
High School Diploma -
Dominguez High School
Paramount, CA06-2005
Some College (No Degree) - Nursing
St Francis Career College
Lynwood, CASkills
- Claims processing
- Benefits verification
- Case management
- HIPAA compliance
- Insurance negotiation
- Medical terminology
- Documentation management
- Data accuracy
- Performance monitoring
- Service delivery coordination
- Customer relationship management
- Data entry
- Microsoft office
- Microsoft Word
- Time management
- Multi-task management
- Organization
- Attention to detail
- Problem solving
- Critical thinking
- Conflict resolution
- Collaborative teamwork
- Effective communication
- Excellent communication
- Virtual communication
- Adaptive team player
- Medical terminology
- Data accuracy
- Time management
References
References available upon request.
Timeline
Benefits/ Claims Respresentive
United Healthcare
01.2024 - Current
Intensive Case Manager
Amity Foundation
09.2018 - 02.2021
Retail Operations Supervisor
AT&T Mobility
11.2014 - 09.2018
Emergency roadside service supervisor
Automobile Club of Southern California
09.2013 - 11.2014
Customer Service Manager
T-Mobile
06.2008 - 09.2013
High School Diploma -
Dominguez High School
Some College (No Degree) - Nursing
St Francis Career College