Jolene Victoria
Flushing,NY
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
22
22
years of professional experience
Work History
Medical Claims Examiner
Local 272 Welfare Fund
02.2013 - Current
- Verified patient insurance coverage and benefits for medical claims.
- Assist healthcare providers and patient's with claim inquiries.
- Examined claims forms and other records to determine insurance coverage.
- Processed insurance payments and maintained accurate documentation of payments.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Reviewed police reports and medical treatment records to determine extent of liability.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Prepared documents for managers or legal personnel.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Researched and resolved complex medical claims issues to support timely processing.
- Negotiated settlement agreements to resolve disputes.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Monitored and updated claims status in claims processing system.
- Paid or denied medical claims based upon established claims processing criteria.
Senior Bank Teller
Astoria Federal Savings Bank
06.2009 - 02.2013
- Answered inquiries regarding checking and savings accounts and other related products.
- Managed daily bank operations by processing customer transactions and providing exceptional customer service.
- Managed a sales team of 5 and trained new tellers on bank procedures and customer service standards.
- Ranked top ten seller in the district.
- Developed and implemented innovative strategies to improve customer satisfaction and increase sales.
- Cross-sold insurance, loans and other bank products.
- Referred customers to other banking departments for specialized services.
- Designed and implemented sales training program and documentation.
- Trained staff on to recognize and prevent fraudulent activities and suspicious transactions.
- Assisted customers with setting up or closing accounts, completing loan applications, and signing up for new services.
- Identified potential needs through observation, questioning, and listening.
- Assessed training program effectiveness on regular basis and improved upon deficient areas.
Sales Associate
The Body Shop
08.2007 - 03.2008
- Stocked merchandise, clearly labeling items, and arranging according to size or color.
- Recommended complementary purchases to customers, increasing revenue.
- Utilized upselling techniques to promote additional products and increase sales.
- Prioritized helping customers over completing other routine tasks in store.
- Maintained clean sales floor and straightened and faced merchandise.
- Monitored customers for signs of security concerns and escalated issues to management.
Community Projects Volunteer
The Body Shop
01.2007 - 02.2007
- Involved with the Giving Back to Our Communities program.
- Gained knowledge and experience working with children in educational setting.
- Planned and delivered numerous activities and special events.
- Developed and implemented strategies to enhance quality of social services.
Professor's Assistant/ Research Assistant
Long Island University- CW Post
09.2003 - 05.2004
- Checked assignments, proctored tests and provided grades according to university standards.
- Prepared letters of recommendation for students looking to obtain internships and cooperative opportunities.
- Monitored student progress to identify weaknesses and provide recommendations for improvement.
- Helped students develop diligent study habits and strategies to achieve successful outcomes.
- Documented attendance and completed assignments to maintain full class and student records.
- Ran errands and provided general office support in a professional environment.
- Recorded and analyzed data to produce reports of results.
- Reviewed documents and data to identify trends and patterns.
- Created surveys and questionnaires to collect data for research projects.
- Gathered, arranged, and corrected research data to create representative graphs and charts highlighting results for presentations.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Sales Specialist
The Home Depot Inc
10.2002 - 10.2007
- Developed and maintained strong working relationships with professionals within assigned territory.
- Created professional sales presentations and seminars to effectively demonstrate product features and competitive advantages.
- Prepared merchandise for sales floor by pricing or tagging.
- Ordered products for the store and customers, including installations.
- Developed and implemented marketing plans to increase brand awareness and drive sales.
- Trained and mentored new sales representatives.
- Provided first-rate service to all customers and potential customers.
- Showcased product features to customers and discussed technical details to overcome objections and lock in sales.
- Educated customers about product features and benefits to aid in selecting best options for each individuals' needs.
- Supported retail distributors, dealers and customers through in-person and telephone support.
- Developed and maintained strong working relationships with professionals within assigned territory.
- Participated in The Children's Workshop, where children were guided in various building projects.
Medical Receptionist
Manhasset Physical Therapy
03.2003 - 07.2003
- Performed various administrative tasks by filing, copying and faxing documents.
- Supported office staff and operational requirements with administrative tasks.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Managed multi-line phone system and pleasantly greeted patients.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
Camp Counselor
Shibley Day Camp
06.2001 - 08.2002
- Evaluated campers' progress and provided feedback to parents.
- Supervised camper activities to address behavioral issues and promote fun, safety and inclusivity for a group of 12.
- Assisted in preparing recreational materials and supplies for each activity.
- Instructed campers to observe proper behavior and etiquette to avoid conflicts and unruly activities.
- Encouraged team performance to increase camaraderie, trust and rapport.
- Collaborated with other camp counselors to design fun and enriching learning activities for campers.
- Implemented rules and regulations to enforce discipline and compliance.
Education
Master of Arts - Human Resources Management
Webster University
London, UK08.2008
Bachelor of Arts - Psychology
Long Island University- CW Post
Greenvale, NY05.2004
Skills
- Insurance Claims Management
- Litigation Support
- Benefits Verification
- Microsoft Office
- Retail Sales Customer Service
- Process Transactions
- Team Development
- Staff Training
- Customer Inquiries
- Time Management
Accomplishments
- Documentation - Wrote and edited documents to keep staff informed on policies and procedures.
- Supervised team of five staff members.
- Recognized- Top sales in the the district.
- Achieved- increased team sales through effectively helping with customer service skills and sales training.
Timeline
Medical Claims Examiner
Local 272 Welfare Fund
02.2013 - Current
Senior Bank Teller
Astoria Federal Savings Bank
06.2009 - 02.2013
Sales Associate
The Body Shop
08.2007 - 03.2008
Community Projects Volunteer
The Body Shop
01.2007 - 02.2007
Professor's Assistant/ Research Assistant
Long Island University- CW Post
09.2003 - 05.2004
Medical Receptionist
Manhasset Physical Therapy
03.2003 - 07.2003
Sales Specialist
The Home Depot Inc
10.2002 - 10.2007
Camp Counselor
Shibley Day Camp
06.2001 - 08.2002
Master of Arts - Human Resources Management
Webster University
Bachelor of Arts - Psychology
Long Island University- CW Post
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