Leonor Juliana Coello

• Reviewed and adjudicated paper/electronic claims under general supervision
• Assessed claims for proper handling and adjudication in accordance with organizational policies and procedures.
• Analyzed and resolved non-adjudicated claims, identifying key processing requirements based on contracts, policies, and procedures.
• Processed product or system-specific claims to ensure prompt payment generation, deductibles and maximums calculation, and resolution of pending claims.
• Used multiple systems and automated processes to enable accurate completion of pending claims, ensuring timely considerations in adherence to medical policy.
• Utilizes quality team for unclear procedures and difficult claims, receiving coaching from leadership.

• Assisted with health and benefit matters for members on a daily basis, including issues related to health, pension, and SRSP/401K.
• Handled assigned tasks within specified timeframes while under supervision.
• Collected and analyzed high volume of data/information to successfully resolve customer's problems and issues pertaining to customer service policies and regulations.
• Enhanced knowledge of medical, mental health, pension, disability STD compensation, and 401K terminology.
• Assisted members in person with health benefits, eligibility, and release of information forms and documents at the welcome center.
• Provided support in managing social worker assistance information, documents, and forms.
• Enhanced delivery of life insurance, long-term disability (LTD), and short-term disability (STD) benefits.
• Resolved escalations and resourcing system problems efficiently.
• Served as Dental Backup, handling dental appointment scheduling and clarifying Dental Center office guidelines, procedures, and policies.
• Provided alternative dental care support to patients.
• Provided in-person assistance to members in seminar district meeting, explaining the benefits and features of 5 Star centers.
• Supervised training sessions for new hires in both MS and Dental Reps live training.

● Conducted daily monetary transactions in excess of $150,000. Organized and
prepared daily transactions profile for branch management. Courteously assisted
over 300 Spanish and English speaking customers per day in a high-pressure and
fast environment.
● Assisted with bank opening/closing procedures.
● Help training new employees and answering co-worker questions.
● Counted and replenished ATM's.
● Providing excellent service while solving customers problems.
● Assisted opening accounts and admitting clients to safe boxes.
● Processed money transfers to foreign countries.
● Balanced bank's vault with over 900 thousand USD in it daily.