Irasel Delgado
Brownsville
Summary
Universal Senior Representative with three years of experience in client support and claims administration seeking a Voluntary Benefits Wellness Claim Specialist role. Skilled in STD, FMLA, ADA, LTD, Voluntary benefits, company leaves, State PFL and adept at facilitating claim processing and coordinating medical documentation. Proven track record in delivering customer satisfaction and handling complex inquiries with clear communication.
Resourceful Senior Representative known for high productivity and efficient task completion. Specialize in client relationship, conflict resolution, and strategic communication. Excel in teamwork, adaptability, and problem-solving to enhance organizational effectiveness and customer satisfaction.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Universal Senior Representative Special Handling
New York Life Group Benefit Solutions
Brownsville
05.2023 - Current
- Address client inquiries regarding leave policies, including FMLA, ADA, Voluntary Benefits, LTD, Company leaves and Paid Family Leave, ensuring effective communication and resolution.
- Coordinate information and document retrieval to support claim processing, and guide claimants through activation and extension of leave claims.
- Manage intermittent FMLA time within designated systems, approving time accurately and clarifying policy details to claimants regarding their short-term disability benefits.
- Resolved escalated customer complaints in a timely manner.
- Answered questions and resolved concerns for customer support.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Participated in regular team meetings to discuss performance, strategies, and goals.
- Responded to customer inquiries and complaints, providing timely and effective solutions to maintain high service standards.
- Assist customers on their Voluntary Benefits inquiries such as Hospital indemnity, Accident, Critical Illness. Providing claim and payment status and advice if documentation is needed.
- Assisting customers on Long term disability inquiries and status updates.
- Requesting Medical records to healthcare providers when needed.
- Gathering initial investigations for claims.
- Assisted with Quality Assurance, grading calls for new hires.
ITT Representative
New York Life Group Benefit Solutions
09.2022 - 05.2023
- Addressed inbound customer inquiries regarding various leave policies, including Family Medical Leave and Americans with Disabilities Act, ensuring clarity and understanding of complex regulations.
- Managed and tracked intermittent leave reports, delivering timely and accurate determinations on employee leave statuses.
- Conducted thorough research on customer accounts and entered data into company systems, facilitating the provision of precise leave-related information and required documentation guidelines.
Retention Department
Spectrum
03.2021 - 08.2022
- Addressed customer inquiries, providing tailored solutions and product recommendations to enhance their connectivity experience.
- Delivered customer satisfaction through effective communication and introduction of relevant new services backed by data-driven insights.
- Assisted in informed decision-making by thoroughly understanding and aligning with business customers' needs and objectives.
Front Desk - Operations
Rodeo Dental and Orthodontics
02.2011 - 06.2017
- Managed daily office operations, ensuring high engagement and proper execution of all administrative functions.
- Coordinated patient appointments, achieving an 80-95% patient show rate through effective scheduling strategies.
- Processed various forms of payments and performed end-of-day ledger consolidations, while also auditing practice documentation for accuracy before submission to corporate.
- Delivered comprehensive customer service, including patient care coordination with multiple dental specialties and effective communication with referring offices.
Education
High School Diploma - General Studies
Rivera High School
Brownsville, TXSkills
- Customer Service
- Communication
- Problem Solving
- Attention to Detail
- Conflict Resolution
- Bilingual
- Call escalation handling
- Policy interpretation
- Teamwork
Certification
Dental Assistant, South Texas Vocational Technical Institute, 2011
Timeline
Universal Senior Representative Special Handling
New York Life Group Benefit Solutions
05.2023 - Current
ITT Representative
New York Life Group Benefit Solutions
09.2022 - 05.2023
Retention Department
Spectrum
03.2021 - 08.2022
Front Desk - Operations
Rodeo Dental and Orthodontics
02.2011 - 06.2017
High School Diploma - General Studies
Rivera High School