Summary
Overview
Work History
Education
Skills
Websites
Timeline
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Mario Barahona

Boynton Beach,FL

Summary

Bilingual claims processing specialist, recognized for exceptional productivity and precision in policy management. Expertise in analyzing claim details, navigating complex policy databases, and enhancing customer communication. Strong problem-solving abilities and adaptability contribute to effective teamwork and successful resolution of intricate situations. Aiming to leverage these skills to drive operational efficiency and improve client satisfaction.

Overview

31
31
years of professional experience

Work History

Claims Processor

NationS afe Drivers
Boynton Beach, FL
05.2022 - Current
  • Monitored pending claims to ensure timely resolution.
  • Handled workload with efficiency while adhering to productivity and quality standards.
  • Processed claims in compliance with quality and production guidelines.
  • Resolved complex issues associated with denied or underpaid claims through negotiation with payers.
  • Assisted new policyholders with processing claims.
  • Evaluated claim forms and supporting documents to assess coverage.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Ensured accuracy in claim data before processing.
  • Maintained accurate records of all processed claims in accordance with departmental requirements.
  • Facilitated actions and resolutions through translation of customer and internal documents.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Performed additional duties as requested by management team.
  • Managed a substantial number of incoming claims following established protocols.
  • Entered claim information accurately into database systems.
  • Collaborated with fellow team members to manage large volume of claims.

Customer Service Specialist

Goodyear Tire & Rubber
Boynton Beach, FL
06.2021 - Current
  • Upheld strict quality control policies and procedures during customer interactions.
  • Documented conversations with customers to track requests, problems and solutions.
  • Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
  • Recommended improvements to products and services to mitigate complaints.

Service Writer/Customer Service Representative

Walmart
Boynton Beach, FL
07.2017 - 11.2019
  • Worked with sales personnel to price and schedule repair needs on new and used vehicles.
  • Presented accurate estimates to inform customers of all service charges and expectations.
  • Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
  • Interfaced with technicians, parts department and managers to stay on top of availability and service procedures.
  • Prepared, completed and processed customer account forms and database changes.
  • Conferred with customers to understand service needs and write up accurate orders.
  • Collected customer feedback and recommended procedural or product changes to enhance future service delivery.
  • Discussed options with customers, helping each make optimal choices for individual needs.
  • Promoted add-on services to increase department revenue, increasing bills % on average
  • Tracked job status by entering work orders and change orders into database.
  • Scheduled and coordinated work for more than 30 customers each day in fast-paced setting.
  • Answered daily phone calls to resolve customer issues efficiently.
  • Oversaw warranty counseling process to manage expense controls.
  • Reviewed all policies to establish and enforce rules when customers request certain jobs.
  • Performed store opening duties, including counting cash drawers and checking all equipment for proper functioning.
  • Maintained calm, friendly demeanor with upset customers to de-escalate stressful situations.
  • Consulted with customers to determine best methods to resolve service and billing issues.
  • Answered customer questions and addressed concerns, resulting in 20% reduction in complaint calls.
  • Developed new customer prospects or referrals each time after every job.
  • Investigated technical issues using knowledge base and personal experience to complete timely resolutions.
  • Exceeded team goals and collaborated with staff to implement customer service initiatives.
  • Worked with managers to develop service improvement initiatives.
  • Documented conversations with customers to track requests, problems and solutions.
  • Met and exceeded productivity targets by handling every interaction with top-notch customer service.
  • Informed customers about billing procedures, processed payments and provided payment option setup assistance.

Tree Service/Owner Operator Truck Driver

Seaside Tree Service
Boynton Beach, FL
07.2015 - 12.2017
  • Remained attentive to order cues to expedite work.
  • Created landscape designs to be presented to clients.
  • Checked all machinery and performed routine maintenance to prevent machine malfunction.
  • Removed debris from work site and followed proper disposal practices.
  • Performed upkeep work for garden areas and landscaping greenery to enhance property appearance and plant health.
  • Managed crew of 3 to 6 workers to strategically plan and coordinate jobs.
  • Trimmed shrubbery and trees and carried out general garden maintenance.
  • Diagnosed plant-related problems and diseases to treat disease and prevent further infestation.
  • Successfully led key projects which resulted in more clientele.
  • Planned and executed daily projects.

Wharehouse

Ambassador Books Service
Farmingdale, NY
04.1994 - 02.2011
  • Planned and executed daily projects.
  • Counted and stocked merchandise as specified by inventory control log.
  • Inspected and moved products to designated areas in warehouse.
  • Contributed ideas on ways to improve or optimize warehousing procedures.
  • Loaded perishable and non-perishable items into trucks according to planned delivery schedules.
  • Identified defective, lost or missing merchandise and promptly reported issues to supervisor.
  • Staged products between receiving, storage and shipping areas to accurately transfer items.
  • Unloaded freight using pallet jacks to transport heavy items to locations in warehouse.
  • Exceeded specific team goal by partnering with staff to share and implement best practices.
  • Received, stored, and shipped goods and materials.
  • Examined incoming and outgoing shipments, rejected damaged items and appropriately recorded any discrepancies.
  • Optimized project completion time by multitasking duties using heavy equipment.
  • Aided senior leadership during executive decision-making process by generating productivity records.

Education

Some College (No Degree) - Academics

Five Towns College
Huntington Station, NY

Skills

  • Shipping and receiving
  • Product verification
  • Warehouse operations
  • Material handling
  • Wrapping and boxing
  • Inventory organization
  • Inventory control
  • Stockroom procedures
  • Adaptive team player
  • Dependable and reliable

Timeline

Claims Processor

NationS afe Drivers
05.2022 - Current

Customer Service Specialist

Goodyear Tire & Rubber
06.2021 - Current

Service Writer/Customer Service Representative

Walmart
07.2017 - 11.2019

Tree Service/Owner Operator Truck Driver

Seaside Tree Service
07.2015 - 12.2017

Wharehouse

Ambassador Books Service
04.1994 - 02.2011

Some College (No Degree) - Academics

Five Towns College

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Mario Barahona