Business-minded Claims Analyst with exemplary skills in customer service, time management and service coordination. Bringing over 10+ years of related experience combined with superior mathematical abilities. Pursuing similar position with expanding insurance company.
Hi, I’m
Mario Charity Jr
Washington,DC
Summary
Overview
13
years of professional experience
Work History
Centene Corporation
Claims Analyst
06.2022 - 12.2023
Job overview
- Reduced claims processing time by implementing efficient analytical techniques and strategies.
- Streamlined workflow processes for improved efficiency and reduced claim resolution times.
- Collaborated with cross-functional teams to develop best practices for claim handling procedures.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Conducted thorough investigations into each claim, gathering relevant data and claim documentation to support approval or denial decisions.
- Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
Robert Half - contracted by Centene Corporation
Member Services Associate
12.2021 - 06.2022
Job overview
- Enhanced member satisfaction by providing exceptional customer service and promptly addressing inquiries.
- Assisted in the retention of members through timely problem resolution and personalized support.
- Assisted members with correcting account, service, and system issues by educating on required forms and technical processes.
- Served as a liaison between members and other departments, facilitating smooth communication and issue resolution.
- Handled sensitive situations with discretion, protecting member privacy while resolving conflicts swiftly.
- Verified payments for memberships, ensuring accuracy and timeliness in financial transactions.
- Learned internal systems and related service role duties to provide skilled team backup in handling customer demands.
Robert Half - contracted by Protiviti Gov't Services
Claims Service Representative
07.2021 - 12.2021
Job overview
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Collaborated with cross-functional teams to optimize claims handling procedures, resulting in improved productivity.
- Reduced fraudulent claims by conducting thorough investigations and collaborating with cross-department agencies.
- Assisted claimants in navigating the unemployment benefits system, addressing concerns, and answering inquiries promptly.
- Expedited claim approvals by effectively prioritizing workload and managing deadlines.
- Handled escalated claimant issues professionally, working towards satisfactory resolutions without compromising company policies or procedures.
Executive Decisions - contracted by Westat
Help Desk Support
06.2021 - 12.2021
Job overview
- Maintained detailed records of candidate interactions, ensuring accurate documentation and tracking of recruitment efforts.
- Provided valuable input during weekly meetings with HR team to discuss progress on ongoing recruitment initiatives, challenges faced, and solutions implemented.
- Established effective rapport with candidates through timely follow-ups and transparent communication, ultimately leading to improved candidate experience and retention.
- Utilized VOIP applicant tracking systems effectively, improving overall efficiency of the recruiting process.
- Supported hiring process by communicating with applicants, conducting reference checks and completing various paperwork.
- Attended trainings and weekly meetings to further knowledge to excel with company
HMS Host
Mailroom Associate
10.2019 - 03.2020
Job overview
- Reduced processing time for incoming mail by utilizing automated equipment and optimizing workflow processes.
- Maintained a well-organized mailroom environment, enabling efficient operations and easy access to materials.
- Increased accuracy in package tracking by maintaining detailed logs of inbound and outbound shipments.
- Supported administrative tasks such as data entry, filing, and supply inventory management in addition to core mailroom duties.
- Maintained up-to-date knowledge of postal regulations and shipping requirements, ensuring compliance across all aspects of the mailroom operation.
- Operated postage meters, mail sealers and labeling machines.
- Supported administrative tasks such as filing, data entry, and document preparation for more efficient office workflow.
Apex Systems - contracted by Avaya IT Gov't Solutions
Help Desk Analyst
07.2018 - 09.2018
Job overview
- Monitor client network using Solarwind/ NetIQ and responds to network events regarding deterioration in performance while implementing established actions to restore network functionality
- Investigate, document and diagnose red alert calls to resolve service affecting issues across multiple service platforms
- (create, resolve, escalate and manage through to resolution) using Remedy and Service Now applications
- Provided Tier 1 IT support to non-technical internal users through desk side support services.
- Collaborated with IT team members to identify trends in reported issues, leading to proactive solutions for recurring problems.
- Supported end-users in software installations, hardware upgrades, and network troubleshooting to optimize system performance.
- Maintained detailed documentation of all help desk interactions for future reference and analysis.
- Utilized ticketing systems to manage and process support actions and requests.
Trusted Health Plan
Member Services Representative
02.2017 - 12.2017
Job overview
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
- Assisted members with account management, including updating personal information and setting up automated payments.
- Collaborated with team members to ensure seamless operations during peak hours or staff shortages.
- Participated in community outreach events as a representative of the health plan, promoting its mission and values within the local area.
- Partnered with other departments facilitating smooth resolution of complex cases resulting in improved member experience.
- Responded to customer calls and emails to answer questions about products and services.
Midtown Group - contracted by Office of Tax & Revenue
Customer Service Tax Specialist (E-Services)
10.2016 - 02.2017
Job overview
- Track documents and process request for waivers of penalties and interest on accounts
- Managed tax submissions and made sure all information complied with regulations.
- Respond to taxpayer inquiries ranging from tax delinquencies, penalty, interest accrued and general information relating to filing individual/business tax returns
- Provide 1st line of support for technology problems by troubleshooting issues related to customer browsers and password resets.
- Collaborated with cross-functional teams to ensure seamless communication and coordination on tax-related matters.
- Conducted comprehensive research on complex tax regulations, staying up-to-date on the latest changes and updates.
- Provide technical assistance and guidance to taxpayers utilizing e-services via email, telephone along with web messages to submit tax returns
- Maintained strict compliance with all federal, state, and local tax laws while preparing client returns.
- Implemented automated systems for tracking client information, significantly reducing errors and increasing productivity.
- Researched complex tax issues utilizing online resources and professional tax software.
Midtown Group - Contracted By DC Office Of Superintendent Of Education
Dispatcher
07.2016 - 10.2016
Job overview
- Utilize ticket system to file DOT reports for emergencies (accidents, incidents, medical)
- Monitoring traffic situations giving detailed logistical instructions to drivers
- Attend monthly trainings to adhere to system and policy changes.
- Enhanced communication with first responders by maintaining updated contact information and utilizing clear, concise language during dispatches.
- Managed high-stress situations calmly and effectively, ensuring timely assistance to those in need.
- Ensured compliance with local, state, and federal regulations related to emergency communications.
- Demonstrated adaptability in evolving situations by adjusting strategies in real-time as new information became available.
- Directed dispatching, routing, and tracking of 600 fleet vehicles.
ATR-1 - contracted by Kaiser Permanente
Enrollment Specialist
09.2015 - 02.2016
Job overview
- Initiates contact with Client to perform Client facing meeting
- Contributed to a positive work environment by fostering strong working relationships among colleagues.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers
- Utilize QA controls to facilitate accurate and timely processing of membership information, contract validation and invoice accuracy
- Schedule appointments and send correspondence for OAD members
- Utilized queue ticketing system for processing unresolved issues
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Provides and uses educational brochures and other printed materials to educate members as well as up to date on key programs to provide the best care for members.
- Enhanced customer service by promptly addressing inquiries and resolving issues in a timely manner.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
FEMA / NFIP
Call Center Associate
03.2011 - 04.2014
Job overview
- Resolve problems by clarifying issues; researching, explaining answers and alternative solutions, implementing solutions
- Collaborated with cross-functional teams to resolve complex issues, ensuring a seamless customer experience.
- Streamlined call handling processes for improved efficiency and reduced wait times.
- Effectivity managed high-volume inbound calls, maintaining composure and professionalism under pressure.
- Managed all calls efficiently in complex, fast paced and challenging call center environment
- Utilized advanced problem-solving skills to address caller concerns effectively while adhering to company guidelines.
- Gathered and verified all required customer information for tracking purposes
- Analyzed and escalated complaints, issues and grievances to designated departments for investigation and response.
Skills
- Help Desk
- ServiceNOW
- Claims Analysis
- Data Interpretation
- Claims Review
- Payspan
- Analytical Skills
- MIDAS
- MiWorks
- Salesforce
- Caremark
- Epaces
- Payspan
Timeline
Claims Analyst
Centene Corporation
06.2022 - 12.2023
Member Services Associate
Robert Half - contracted by Centene Corporation
12.2021 - 06.2022
Claims Service Representative
Robert Half - contracted by Protiviti Gov't Services
07.2021 - 12.2021
Help Desk Support
Executive Decisions - contracted by Westat
06.2021 - 12.2021
Mailroom Associate
HMS Host
10.2019 - 03.2020
Help Desk Analyst
Apex Systems - contracted by Avaya IT Gov't Solutions
07.2018 - 09.2018
Member Services Representative
Trusted Health Plan
02.2017 - 12.2017
Customer Service Tax Specialist (E-Services)
Midtown Group - contracted by Office of Tax & Revenue
10.2016 - 02.2017
Dispatcher
Midtown Group - Contracted By DC Office Of Superintendent Of Education
07.2016 - 10.2016
Enrollment Specialist
ATR-1 - contracted by Kaiser Permanente
09.2015 - 02.2016
Call Center Associate
FEMA / NFIP
03.2011 - 04.2014
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