HELENA STANLEY
BUFFALO
Summary
Customer service specialist with 7 years of experience in claims processing and customer relationship development. Demonstrates strong skills in reporting and analysis, organization, and project management, contributing to enhanced operational efficiency and customer satisfaction. Adept at fostering cross-departmental cooperation to implement process improvements and committed to delivering exceptional service with a focus on accuracy and timely communication.
Professional claims specialist with strong record in handling and resolving complex claims efficiently. Adept at analyzing data, identifying discrepancies, and providing solutions that drive positive outcomes. Effective team collaborator with focus on achieving results and adapting to evolving requirements. Skilled in negotiation, customer service, and regulatory compliance, consistently ensuring accuracy and fairness.
Overview
7
7
years of professional experience
Work History
Claims Specialist
Independent Health
09.2019 - 10.2024
- Streamlined claims processing, improving efficiency and accuracy across departments
- Authored comprehensive weekly reports, enhancing project transparency and accountability
- Trained new adjusters, fostering skill development and adherence to best practices
- Reviewed critical documents, ensuring thorough and precise claim investigations
- Maintained proactive communication, ensuring timely updates to all stakeholders
- Analyze complex medical records and police reports to determine claim validity, ensuring accurate assessments and fair settlements for stakeholders
- Streamline claims processes, reducing turnaround time and enhancing customer satisfaction through efficient documentation and timely follow-ups
- Foster cross-departmental cooperation to identify and implement process improvements, enhancing overall operational efficiency
- Followed up with customers on unresolved issues.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
Customer Service Representative
Lincare
05.2019 - 08.2019
- Built customer loyalty through personalized support, enhancing satisfaction and retention
- Resolved customer complaints swiftly, improving service efficiency and client trust
- Identified upselling opportunities, increasing sales and customer value
- Collected feedback to refine service delivery, boosting overall performance
- Developed creative solutions for complex customer issues, improving first-call resolution rates
- Proposed and implemented new follow-up strategies
- Meticulously maintained customer records, ensuring accurate information dissemination
- Conducted thorough product knowledge training to enhance service quality
- Provided empathetic support to customers, effectively de-escalating difficult situations
- Mentored new team members on best practices in customer care
Customer Service Representative
Upstate Farms
01.2019 - 05.2019
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Educated customers about billing, payment processing and support policies and procedures.
- Met customer call guidelines for service levels, handle time and productivity.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Responded to customer requests for products, services, and company information.
Customer Service Representative
Bank of America
03.2018 - 07.2018
- Supported administrative tasks, ensuring efficient data management and report preparation
- Collaborated with cross-department teams to enhance process efficiency and project progress
- Trained new adjusters on claims best practices, improving team competency and service quality
- Reviewed claims documentation to assess coverage, recommending payment or denial decisions
- Maintained timely follow-ups on open claims, keeping stakeholders informed and satisfied
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Followed-through on all critical inter-departmental escalations to increase customer retention rates.
- Met customer call guidelines for service levels, handle time and productivity.
Customer Service Representative
Liazon
06.2017 - 11.2017
- Resolved customer issues swiftly, boosting satisfaction and loyalty
- Recorded customer interactions meticulously, aiding future reference
- Collaborated with sales to address inventory challenges effectively
- Promoted products during interactions, enhancing service experience
- De-escalated concerns calmly, maintaining customer trust
Education
Bachelor of Science - Criminal Justice
Southern New Hampshire University
Hooksett, NH06-2024
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
- Microsoft office
- Claims analysis
- Documentation review
- Allocating claims
- Time management
- Decision-making
- Critical thinking
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Customer Follow-up - Ensured that customers were satisfied with company products and services by doing purchase follow-up calls.
- Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.
Languages
English
Native or Bilingual
Spanish
Elementary
Timeline
Claims Specialist
Independent Health
09.2019 - 10.2024
Customer Service Representative
Lincare
05.2019 - 08.2019
Customer Service Representative
Upstate Farms
01.2019 - 05.2019
Customer Service Representative
Bank of America
03.2018 - 07.2018
Customer Service Representative
Liazon
06.2017 - 11.2017
Bachelor of Science - Criminal Justice
Southern New Hampshire University
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