Maria Angelica Pineda
San Ysidro,CA
Summary
Resourceful Insurance Specialist known for high productivity and efficient task completion. Specialized skills include risk assessment, policy analysis, and claim processing, ensuring comprehensive coverage tailored to client needs. Excel in communication, problem-solving, and adaptability, leveraging these soft skills to navigate complex insurance landscapes and deliver optimal solutions for both clients and employers.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Insurance Specialist
San Ysidro Health
San Ysidro, CA
01.2018 - 06.2024
- Analyzed financial statements to determine appropriate levels of coverage for clients.
- Maintained accurate records of all transactions related to insurance policies.
- Provided guidance to customers regarding available insurance plans and their benefits and limitations.
- Responded promptly to customer inquiries about their policies and provided timely updates as needed.
- Reviewed insurance policies to ensure compliance with existing regulations.
- Ensured that customer data was kept confidential at all times in accordance with applicable laws and regulations.
- Participated in training programs designed to enhance knowledge base in areas such as underwriting, sales, product development.
- Analyzed insurance organizational structures, business and intermediaries, studying common clauses, policies and insurance contracts.
- Resolved routine and complex issues by performing detailed research.
- Collaborated with carriers to resolve discrepancies in insurance payments.
- Managed denials, late payments, extensions and other special circumstances by following up with relevant parties.
- Engaged customers and provided high level of service by carefully explaining details about documents.
- Conducted telephone appointments with prospective clients to build rapport and sell insurance services.
- Conducted meetings or phone calls with potential clients to present insurance policies and answer questions.
- Explained coverage options to potential policyholders, answering questions or concerns.
- Monitored clients' insurance coverages to ensure changing needs were met.
- Improved data collection accuracy by structuring systems for desktop spreadsheets.
- Calculated premiums and established payment methods, receiving customer payments and issuing receipts.
Sales Associate
Factory 2 U
Lemon Grove, CA
03.2007 - 03.2012
- Performed cashier duties such as accepting payments, issuing receipts and counting money back change.
- Assisted customers with product selection, sizing and styling.
- Processed credit card transactions quickly and securely.
- Conducted inventories on a regular basis to track stock levels.
- Maintained up-to-date knowledge of store merchandise and policies.
- Handled customer complaints in a professional manner.
- Greeted customers and provided exceptional customer service.
- Maintained cleanliness of store environment including floors, windows, displays.
- Organized stockroom shelves according to size, color or style.
- Processed returns, exchanges, and refunds in accordance with company policies.
Sales Associate
See's Candies
San Diego, CA
11.2007 - 01.2008
- Performed cashier duties such as accepting payments, issuing receipts and counting money back change.
- Assisted customers with product selection, sizing and styling.
- Conducted inventories on a regular basis to track stock levels.
- Greeted customers and provided exceptional customer service.
- Processed transactions using a point-of-sale system.
- Restocked shelves as needed to ensure sufficient inventory levels.
Education
Certificate - Medical Billing And Coding
Brightwood College - Riverside
Riverside, CA08-2018
Skills
- Regulatory compliance understanding
- Account management expertise
- Policy analysis
- Account Management
- Reporting skills
- Claims Management
- Customer Service
- Client Retention
- Client Relations
- Policy Renewals
- Customer follow-up
- CRM Software
- Lead Development
- Client Account Management
- Asset protection expertise
- Policy Knowledge
- Legal Codes
- Operations Management
- New Client Acquisition
- Regulatory Compliance
Accomplishments
- President's List academic achievement
Languages
English
Professional
Spanish
Professional
Certification
- Knowledge of UB04 an d CMS 1500 forms
- CPR/BLS certified
- ICD-10,ICD-10 PCS CPT and HCPC's coding
References
References available upon request.
Timeline
Insurance Specialist
San Ysidro Health
01.2018 - 06.2024
Sales Associate
See's Candies
11.2007 - 01.2008
Sales Associate
Factory 2 U
03.2007 - 03.2012
Certificate - Medical Billing And Coding
Brightwood College - Riverside
- Knowledge of UB04 an d CMS 1500 forms
- CPR/BLS certified
- ICD-10,ICD-10 PCS CPT and HCPC's coding
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