Liza Sevilla

• Managing daily operations for 70+ MetLife groups, ensuring efficiency and problem resolution.
• Established professional relationships with clients and brokers to foster long-term business partnerships.
• Oversaw direct billing invoices and resolved discrepancies promptly.
• Assisted groups with new hires, terminations, and annual open enrollment processes.
• Addressed employee claim inquiries and generated yearly claim reports.
• Provided timely reports on group tax documents and EOI/Statement of health updates.
• Facilitated weekly meetings with billing and group contacts to address ongoing issues.
• Collaborated effectively with internal and external teams to meet project requirements.

• Utilized proficiency in medical terminology and ICD-10 codes for documentation accuracy.
• Verified medical provider credentials with doctors and specialists to facilitate claim approvals.
• Conducted assessments for benefit approval and ongoing reviews for long-term care eligibility.
• Documented services, healthcare interactions, and collected data for comprehensive evaluations.
• Facilitated onsite nurse evaluations with customers to determine benefit eligibility.

Facilitated assistance for USAA service employees and members regarding insurance policies, including auto, renters, and homeowners. Assisted teammates with best practices, and assistance on customer inquiries and procedures.

• Managed policy openings and closures while providing quotes for new insurance, while also assisting with inquiries on policy coverage, and making changes to existing policies as needed.
• Coordinated the distribution of proof of insurance to members and external entities, such as mortgage and title companies.
• Processed payments over the phone for members' accounts to streamline servicing.

Managed inbound escalation team of specialists addressing complex issues for Citibank banking account holders.

• Resolved escalated issues with policy and procedure inquiries requiring supervisor assistance.
• Mentored team members, offering feedback and promoting best practices for client excellence.
• Collaborated effectively with diverse coworkers to achieve goals related to member products and services.