MAJAVAE HAMILTON
Aubrey,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
7
7
years of professional experience
Work History
Customer Service Representative
Alight
Remote
09.2024 - Current
- Answered customer inquiries and provided accurate information regarding products and services.
- Developed strong relationships with customers by providing personalized assistance and support.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Suggested changes in products, services to improve customer experience, satisfaction levels.
- Developed and implemented new and improved outbound calling processes and scripts, resulting in increased sales and caller engagement.
- Maintained strong call control and quickly worked through scripts to address problems.
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
- Navigated through computer systems to review information and respond appropriately to callers.
- Engaged actively with callers, confirming or clarifying information and diffusing anger.
- Maintained a high call volume of 200+ calls
- Redirected complex or specialized concerns to the appropriate team
Benefits Specialist
Randstad
Richardson, Texas
04.2024 - Current
- Explained the impact of life events such as marriage or divorce on benefits enrollment status.
- Coordinated open enrollment activities including meetings and communication campaigns.
- Compiled data from various sources for reporting purposes.
- Discuss member benefits and eligibility
- Provide eligibility effective dates
- Processed benefit enrollment forms, changes, and terminations.
- Checked accuracy and completeness of benefits applications and documents.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
Total Loss Claims Specialist
EA Renfroe
Birmingham, Alabama
12.2022 - 08.2023
- Developed training materials for staff members on best practices for handling different types of claims.
- Performed periodic audits of closed files to ensure accuracy of documentation and compliance with regulations.
- Participated in continuing education seminars related to industry standards for insurance claims processing.
- Collaborated with other departments within the organization to resolve issues related to claims processing.
- Provided customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Processed payments for valid claims according to established procedures.
- Resolved disputes between claimants and providers through negotiation.
- Investigated complex or high-value claims to identify discrepancies and fraud indicators.
Auto Claims Associate
EA Renfroe
Birmingham, Alabama
02.2022 - 10.2022
- Monitored expenses associated with each claim to ensure they stayed within budget guidelines.
- Communicated regularly with adjusters, attorneys, medical personnel, and law enforcement officers to stay informed about case developments.
- Reviewed and processed auto claims documents to ensure accuracy of information.
- Processed payments for approved claims according to established guidelines.
- Drafted correspondence to inform customers about claim decisions or provide additional information as requested.
- Conducted investigations, gathered evidence, and interviewed witnesses to determine liability in auto accident cases.
- Evaluated existing auto policy coverage levels to recommend changes that would better meet customer needs.
- Investigated fraud incidents by interviewing claimants, gathering evidence, and consulting with experts as needed.
- Ensured compliance with company policies and industry regulations when handling customer complaints or appeals.
Auto Claim Representative
Alacrity Solutions
Lafayette , LA
09.2021 - 11.2021
- Assisted customers with filing auto claims and provided timely updates regarding their claim status.
- Conducted telephone interviews with claimants to gather information about the accident or incident leading up to the claim.
- Performed additional duties as assigned by management team members.
- Resolved customer complaints regarding claims processing in a timely manner.
- Reported changes to the customer's policy or coverage due to a claim settlement.
- Analyzed liability issues related to automobile accidents and disputes between claimants.
Data Entry Associate
Cigna
Plano, Texas
04.2019 - 05.2021
- Updated existing databases with new customer information as required.
- Uploaded and maintained digital records accurately.
- Verified data accuracy in databases and corrected errors.
- Entered customer information into database systems.
- Organized and sorted source documents prior to data entry.
- Scanned and stored files and records electronically to reduce paper files and secure data.
- Maintained data entry requirements by following data program techniques and procedures.
- Adjusted settings for format, page layout and line spacing.
FMLA Intake Specialist
Cignall
Plano, Texas
10.2017 - 04.2019
- Analyzed employee eligibility for FMLA leave based on company policy and federal regulations.
- Responded promptly to inquiries from claimants concerning their rights under the family medical leave act.
- Monitored changes in state or federal laws governing family medical leave act requirements.
- Drafted letters to inform claimant about their rights or decisions made regarding their claim.
- Assisted in developing and administering FMLA policies and procedures.
- Provided guidance to employees on their rights, responsibilities, benefits and obligations under the FMLA law.
- Investigated potential violations of the Family Medical Leave Act by employers or employees.
- Conducted research to obtain information related to FMLA claims processing as required.
- Maintained accurate records of all FMLA leaves taken by employees including filing documents into appropriate folders.
- Communicated regularly with supervisors, managers, HR personnel and other stakeholders to provide updates on status of employee's FMLA leave request.
- Compiled, reviewed and processed FMLA leave requests to ensure compliance with the Family Medical Leave Act.
Education
High School Diploma -
North Mesquite High School
Mesquite, TX05-2012
Bachelor of Science - Early Childhood Education
Texas A&M University - Commerce
Commerce, TXSkills
- Open enrollment
- Relationship Building
- Verbal and written communication
- Employment law knowledge
- MS Office
- Team Management
- Time Management
- Problem-Solving
- Planning
- Project Planning
- Customer Relations
- Problem Resolution
- Flexible and Adaptable
- Multitasking
- Research
- Verbal Communication
- Conflict Resolution
- Understanding of medical terminology
- Medical terminology knowledge
- Medical Terminology
- Claims Investigation
- Order Management experience
- Damage Assessment
- Rules of evidence
- Insurance fraud expertise
- Property claims
- Claims Processing
- Highly motivated
- Technical knowledge
- SAP experience
- 2 years of BRB customer service experience
Timeline
Customer Service Representative
Alight
09.2024 - Current
Benefits Specialist
Randstad
04.2024 - Current
Total Loss Claims Specialist
EA Renfroe
12.2022 - 08.2023
Auto Claims Associate
EA Renfroe
02.2022 - 10.2022
Auto Claim Representative
Alacrity Solutions
09.2021 - 11.2021
Data Entry Associate
Cigna
04.2019 - 05.2021
FMLA Intake Specialist
Cignall
10.2017 - 04.2019
High School Diploma -
North Mesquite High School
Bachelor of Science - Early Childhood Education
Texas A&M University - Commerce
Similar Profiles
Christine GutierrezChristine Gutierrez
Team Specialist at AlightTeam Specialist at Alight
Ashley PizarroAshley Pizarro
Customer Care Representative at AlightCustomer Care Representative at Alight
Sidumi Beteta SaavedraSidumi Beteta Saavedra
Benefits Specialist at AlightBenefits Specialist at Alight