Summary
Overview
Work History
Education
Skills
Work Preference
Timeline
Generic

Kia Buliox

N
Addison,IL

Summary

Responsible Project Coordinator focused on maximizing team productivity with proactive, cross-functional communication and organized approach. Demonstrated track record of accomplishing projects on time and under budget. Offers valuable insight earned over 15 years of career.

Overview

10
10
years of professional experience

Work History

Case Manager Specialist

Ceda
Chicago, IL
08.2021 - Current
  • Prioritized needs and delegated assignments to handle multiple projects simultaneously.
  • Assessed, monitored and reported on work progression.
  • Updated and distributed weekly project schedules and milestones.
  • Produced status reports for customers and senior management.
  • Managed work streams for both routine and special projects simultaneously.
  • Prepared presentations for customers and staff members detailing project scope, progress and results.
  • Introduced change improvement plans to achieve goals, methodologies and initiatives.
  • Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
  • Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations, and procedural costs.
  • Developed and implemented comprehensive case management plans to address client needs and goals.
  • Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
  • Partnered with local organizations to expand access to social and community services.
  • Implemented strategies to increase public awareness of social and community service programs.
  • Monitored program performance and outcomes for successful delivery of services.
  • Managed volunteer programs focused on providing community services to underserved populations.
  • Analyzed trends and data to inform decision-making and program development.
  • Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
  • Assessed community needs and identified resources for social and community service programs.

Front Desk Manager

Wyndham Garden Hotel
Elk Grove Village, IL
07.2021 - 01.2024
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Skilled at working independently and collaboratively in a team environment.
  • Proven ability to learn quickly and adapt to new situations.
  • Excellent communication skills, both verbal and written.
  • Worked well in a team setting, providing support and guidance.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Strengthened communication skills through regular interactions with others.
  • Proved successful working within tight deadlines and a fast-paced environment.
  • Demonstrated strong organizational and time management skills while managing multiple projects.

Quality Assurance Specialist

Allstate Insurance Co
Northbrook, IL
07.2017 - 08.2021
  • Educated customers on special pricing opportunities and company offerings.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Documented customer correspondence in CRM to track requests, problems and solutions.
  • Upheld quality control policies and procedures to increase customer satisfaction.
  • Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
  • Audited customer account information to identify issues and develop solutions.
  • Trained new employees on procedures and policies to maximize team performance.
  • Trained new hires on products and services, best practices and protocols to reduce process gaps.
  • Liaised cross-functionally to develop operational improvement initiatives.
  • Executed on-time and under-budget project management to resolve complex issues.
  • Exceeded company productivity standards on consistent basis.
  • Monitored product standards and quality-control programs.
  • Fixed identified issues to increase productivity and boost workflows.
  • Educated employees on specific QA standards and confirmed maintenance of standards.
  • Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
  • Completed deviation forms and recorded findings of inspection process, collaborating with quality team members and department managers to implement procedural remedies.
  • Fixed identified issues to improve workflows.
  • Recorded findings of inspection process, collaborating with quality team to implement corrective actions.
  • Analyzed quality and performance data to support operational decision-making.
  • Promoted adherence to quality standards by educating personnel on quality control.
  • Reported problems and concerns to management.
  • Completed supporting documentation for testing procedures, data capture forms, equipment logbooks and inventory forms.
  • Collected and analyzed data to measure effectiveness of quality control processes.
  • Mentored and trained new hires, fostering a supportive work environment that facilitated professional growth.

Catastrophe Claims Adjuster

Allstate Insurance Co
Northbrook, IL
09.2014 - 06.2017
  • Managed work streams for both routine and special projects simultaneously.
  • Assessed, monitored and reported on work progression.
  • Updated and distributed weekly project schedules and milestones.
  • Produced status reports for customers and senior management.
  • Liaised with project managers to evaluate project scope and define milestones and deadlines.
  • Researched and analyzed policy contracts to verify proper payment of claims.
  • Answered customer questions regarding deductibles.
  • Coordinated with department leads to identify and outline solutions to client-specified challenges.
  • Developed quality assurance controls for design approaches.
  • Prepared presentations for customers and staff members detailing project scope, progress and results.
  • Introduced change improvement plans to achieve goals, methodologies and initiatives.
  • Verified insurance claims and determined fair amount for settlement.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Prepared summaries of damage, payments, and policy coverage.
  • Examined claims forms and other records to determine insurance coverage.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Organized, planned and documented materials for [Type] claims.
  • Established relationships with clients and insurance companies to foster timely claims resolution.
  • Documented all investigation activity and presented reports to management.
  • Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
  • Substantiated legitimate claims and denied unjustified claims.
  • Maintained suspicious claims database and prepared reports for supervisors.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Negotiated [Type] settlement agreements to resolve disputes.
  • Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.
  • Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
  • Evaluated original investigation reports and documents to resolve secondary concerns.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Visited customer locations to evaluate damage and provided cost estimates for remediation.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
  • Identified suspicious losses and contacted manager for investigative assistance.
  • Analyzed information gathered by investigation and reported findings and recommendations.
  • Documented information gathered in field and uploaded data to company database for efficient processing using [Software].
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Researched claims and incident information to deliver solutions and resolve problems.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Investigated and assessed damage to property and reviewed property damage estimates.

Education

No Degree -

Maclom X College
Chicago, IL
08.1996

Skills

  • Project Coordination
  • Policy and Procedure Development
  • Critical Thinking
  • Decision Making
  • Problem-Solving
  • Multiple Priorities Management
  • Detail Oriented
  • Emotional Awareness
  • Program Development
  • Eligibility Assessments
  • Quality Assurance Controls
  • Telephone Etiquette
  • Area of Expertise Specialized Care
  • Data Entry and Analysis
  • Intervention Plans
  • Annual Case Reviews
  • Multitasking and Organization
  • Resource Management
  • Income Verification
  • Verbal and Written Communication
  • Case Notes
  • MS Office
  • Program Eligibility
  • Case Management Tracking
  • Team Meetings

Work Preference

Work Type

Full Time

Location Preference

RemoteHybrid

Important To Me

Company CultureWork-life balanceCareer advancement401k matchWork from home optionPersonal development programs

Timeline

Case Manager Specialist

Ceda
08.2021 - Current

Front Desk Manager

Wyndham Garden Hotel
07.2021 - 01.2024

Quality Assurance Specialist

Allstate Insurance Co
07.2017 - 08.2021

Catastrophe Claims Adjuster

Allstate Insurance Co
09.2014 - 06.2017

No Degree -

Maclom X College

Similar Profiles

CREATE PROFILE
Kia BulioxN