MARIA T CORREA Diaz
Oakwood,GA
Summary
Accomplished Long Term Disability Claims Manager at New York Life Insurance Co, adept in claims management and relationship building. Leveraged organizational skills and fluency in Spanish to enhance customer satisfaction. Successfully increased add-on business by 87% through effective communication and strategic recommendations. Recognized for problem resolution and contract interpretation expertise.
Overview
32
32
years of professional experience
Work History
Long Term Disability Claims Manager
New York Life Insurance Co
Oakwood, GA
06.2022 - Current
- Maintained organized filing system for client records, providing complete documentation of all interactions.
- Manage the assigned block of claims by regularly talking with and knowing your customers, their level of functioning, and having a command of case facts for each claim in your block.
- Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information
- Documented services and collected required data for evaluation.
- Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
- Respond to all communications within customer service protocols in a clear, concise and timely manner
- Find customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented
- Have discussions with customers and employers regarding return to work opportunities and communicate with an action-oriented approach.
- Handled administrative procedures to meet objectives set by boards of directors or senior management.
- Consulted with staff on resolution of complex service issues.
Disability Specialist
Unum
Oakwood, GA
11.2018 - Current
- Counseled patients on an ongoing basis to assist with challenges
- Built relationships with strategic partners leading to business development opportunities
- Interviewed customers regarding disability and/ or illness issues and reported feedback to the management team
- Obtained patient medical updates, documenting all information into charts
- Used medical history and in-depth interviews to conduct health evaluations
- Assessed customer needs through detailed questioning and presented products to fill those requirements
- Managed productivity through efficient scheduling, task prioritization, and process streamlining
- Educated patients on procedures and treatments, answering questions regarding medical requirements for extensions
- Maintained confidential documentation of patient information to stay compliant with federal regulations
- Inputted information from customer calls and onsite service visits into the company's system
- In-house Spanish interpreter for various departments within the company
Customer Service Representative
ABC Financial Services
Sherwood, AR
01.2016 - Current
- Cross-trained and provided back-up for other customer service representatives when needed
- Served as the company's only bilingual Spanish/English customer service representative
- Answered an average of 100 calls per day by addressing customer inquiries, solving problems, and providing new product information
- Maintained up-to-date knowledge of store policies regarding payments, returns, and exchanges
- Provided an elevated customer experience to generate a loyal clientèle.
Customer Service Professional
American Express
09.2012 - 07.2015
- Home Based
- Documented all customer inquiries and comments thoroughly and quickly
- Recommended and helped customers select merchandise based on their needs
- Coordinated between billing department and customers to resolve problems
- Processed credit payments rapidly and accurately
- Confirmed that appropriate changes were made to resolve customers' problems
- Referred unresolved customer grievances to designated departments for further investigation
- Exercises sound judgment in issuing credits and making exceptions to customer policies to maintain high levels of customer satisfaction
- Placed special merchandise orders for customers
- Extended customer subscriptions, offering discounts and promotions to ensure high customer retention rates
- Informed customers about sales and promotions in a friendly and engaging manner.
Sales Associate
AT&T GA
10.2002 - 07.2011
- Answered customer questions about product availability and shipment times
- Managed a wide variety of customer service and administrative tasks to resolve customer issues quickly and efficiently
- Trained new employees on company customer service policies and service level standards
- Placed special merchandise orders for customers
- Greeted customers in a timely fashion, while quickly determining their needs
- Processed up to 150 customer orders per day
- Tracked down sources of special products and services to meet customers' special needs
- Recommended new telephone services and features to customers, resulting in an 87 % in add-on business.
Supervisor
Orange City Police Dept
Orange City, United States
09.1993 - 02.1999
- Florida
- Responsible for being the first point of contact for Emergency (911) calls, as well as non-emergency calls for information and assistance
- Required to obtain precise information for dissemination to responding emergency personnel while maintaining accurate accounting for police officers, investigators, and other agencies using the computer-Aided Dispatching System
- Supervised the dispatch department to ensure accurate and timely responses
- Responsible for maintaining highly confidential employee records, maintaining absentee records, vacation schedules, and budget for the Communications Division
- Interviewed and recommended the hiring of new personnel for the Communications Center
- Responsible for employee's annual evaluation, performance notices, and disciplinary actions
- Responsible for all portable Ericsson radios and main console maintenance.
Education
High School Diploma -
Seminole Community College
Sanford, FLSkills
- Customer Support and Assistance
- Effective Customer Communication
- Research and Facts Collecting
- Organizational Skills
- Fluent in Spanish
- Problem Resolution
- People Skills
- Computer Skills
- Conflict Resolution
- Good Work Ethic
- Active Listening
- Claims management
- Contract interpretation
- Disability evaluation
- Medical documentation
- Customer eligibility
- Relationship building
Languages
Bilingual professional fluent in Spanish and English, with strong cross-cultural communication skills.
Timeline
Long Term Disability Claims Manager
New York Life Insurance Co
06.2022 - Current
Disability Specialist
Unum
11.2018 - Current
Customer Service Representative
ABC Financial Services
01.2016 - Current
Customer Service Professional
American Express
09.2012 - 07.2015
Sales Associate
AT&T GA
10.2002 - 07.2011
Supervisor
Orange City Police Dept
09.1993 - 02.1999
High School Diploma -
Seminole Community College
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