Maria Perez
Reseda,CA
Summary
Experienced with team leadership and operational management. Utilizes strong organizational skills to optimize workflow and improve team efficiency. Track record of fostering collaborative work environment to achieve collective goals.
Overview
35
35
years of professional experience
Work History
Claims MO Supervisor
Zenith Insurance Co.
Woodland Hills
01.2017 - Current
- Currently I am responsible for overseeing the Medical Only/Fast track department which consists of supervising 6 medical only/indemnity examiners each handling up to 200 files each.
- Analyzed performance metrics to identify areas for improvement and implement strategic solutions.
- Coordinated cross-departmental collaboration to enhance communication and project outcomes.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Resolved conflicts among team members promptly, maintaining a harmonious working environment conducive to productivity.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
- Reduced employee turnover by fostering a positive work environment and providing ongoing feedback to staff members.
- Led team in executing claims processing, ensuring compliance with regulatory standards.
- Mentored staff in customer service excellence, enhancing client satisfaction rates.
Claims Supervisor
Zenith Insurance Co.
01.2012 - 01.2016
- I was responsible for supervising the Ag Unit which consists of 4 examiners and 2 claims assistants. I oversee 400 plus files. I provide guidance and direction to prevent further reserve development and move cases toward resolution.
- Conducted regular performance evaluations to identify training needs and development opportunities.
- Oversaw daily operations to ensure compliance with safety and quality standards.
- Trained and mentored staff to enhance team performance and productivity.
- Managed conflict resolution within teams, promoting a positive work culture.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
Claims Technical Specialist
Zenith Insurance Co.
01.1998 - 01.2012
- Assigned to high profile accounts, responsible for the Managing claims from beginning to resolution of claims files.
- Facilitating resources while, keeping abreast of all issues.
- Planned and thoroughly documented and negotiations settlement in a timely manner.
- Identify abuse, as well as possible fraud issues. Served as a witness in many fraud cases filed in criminal court.
- Maintained open communication with injured workers, insured’s, agents, physicians, etc., to coordinate claim-handling tactics and achieve prompt resolution of cases.
- Provided exceptional customer support, resolving complex technical issues with effective communication skills.
- Managed multiple high-priority projects simultaneously, consistently meeting deadlines while maintaining attention to detail.
Medical Only Examiner/Claims Assistant
Zenith Insurance Co.
01.1993 - 01.1998
- Responsible for the analysis, management of medical only Claims. Provide formal authorization to treating physicians for treatment plans and medical management. As a claim’s assistant my responsibilities included assisting two or three examiners in making benefits payments, obtaining medical status, reviewing all correspondence and separating it by priority, scheduled medical appointments and process wage statements.
Switchboard Operator
Zenith Insurance Co.
01.1991 - 01.1993
- Operated multi-line switchboard to efficiently manage incoming calls and direct inquiries.
- Assisted in reducing hold times with swift call handling and efficient use of switchboard system features.
- Provided exceptional customer service by handling caller requests and resolving issues promptly.
- Maintained accurate call logs and records for internal tracking and reporting purposes.
- Trained new staff on switchboard operations and customer service best practices.
Education
High School Diploma - WCCA, WCCP, Self-Insured designation, Zenith Supervisor training program
Insurance Education Association
Skills
- Excellent Computer skills
- Commitment to learning and achieving personal excellence
- Bilingual (Spanish)
- Goal oriented
- Customer service
- Attention to detail
- Staff management
- Decision-making
Languages
Spanish
Native or Bilingual
Timeline
Claims MO Supervisor
Zenith Insurance Co.
01.2017 - Current
Claims Supervisor
Zenith Insurance Co.
01.2012 - 01.2016
Claims Technical Specialist
Zenith Insurance Co.
01.1998 - 01.2012
Medical Only Examiner/Claims Assistant
Zenith Insurance Co.
01.1993 - 01.1998
Switchboard Operator
Zenith Insurance Co.
01.1991 - 01.1993
High School Diploma - WCCA, WCCP, Self-Insured designation, Zenith Supervisor training program
Insurance Education Association