MEISY GOMERA
Jersey City,NJ
Summary
Driven professional with a wealth of administrative and financial experience. Demonstrated expertise in policy interpretation, claims management, and training. Exemplifies strong critical thinking and organizational abilities while efficiently handling high-profile workloads, processing payments, and maintaining detailed records. Proficient in navigating regulatory compliance requirements and understanding industry practices. Bilingual (English and Spanish), and skilled in fostering positive relationships and adeptly explaining complex matters to the public. Uncompromisingly committed to ensuring words and actions align with the company's mission, values, and ethos.
Overview
16
16
years of professional experience
Work History
Operations Assistant/Dispatcher
Rivas Hotshot
09.2022 - 10.2024
- Reviewed and audited Electronic Logging Device (ELD) data daily to verify accurate timekeeping, rest periods, and driver availability.
- Coordinated with drivers and warehouse teams to minimize delays and ensure on-time delivery and FMCSA safety compliance .
- Trained drivers on DOT inspection readiness , driver qualification files , and maintaining proper logbooks.
Claims Specialist/Claims Technical Expert
Social Security Administration
05.2014 - 08.2022
- Serve as a subject matter expert on complex Social Security policies, providing clarity on ambiguous situations and offering strategic guidance to staff on the application of rules and regulations.
- Prepare and present detailed briefings to Congressional staff, effectively communicating key insights on Social Security policies, programs, and case progress.
- Analyze and resolve challenging claims, identifying critical issues, and delivering expert technical guidance to caseworkers to ensure accurate adjudication.
- Manage and oversee the adjudication of Administrative Law Judge (ALJ) and concurrent disability cases, ensuring precise allowances and denials; act as the Pre-Effectuation Review Contact (PERC) Expediter, optimizing SSI case processing and payment timelines.
- Conduct thorough claimant interviews, validating information, initiating payments, and ensuring accurate disbursements to welfare agencies and legal representatives; oversee the preparation and distribution of notices to maintain streamlined workflows.
- Monitor claim statuses, proactively following up with applicants to collect additional documentation and ensuring all submissions are complete and accurate for timely processing.
- Stay abreast of evolving Social Security laws, regulations, policies, and procedures, ensuring the provision of current, accurate guidance to stakeholders.
- Cultivate strong relationships through effective communication with applicants and representatives, providing essential information about agency resources, eligibility criteria, and benefit options; ensure accurate low-income subsidy assessments.
- Lead training programs for colleagues and claim representative trainees, enhancing team expertise in Medicare Part D processing, Low-Income Subsidy eligibility, and managing abbreviated/deferred SSI applications.
Financial Aid Administrator
Berkeley College
05.2008 - 03.2014
- Guide students and parents through the financial aid process, providing expert advice on opportunities, eligibility, and award recalculations; ensure timely follow-ups and accurate, up-to-date information.
- Manage financial aid databases, ensuring precise processing of loan documents and maintaining 100% completeness of financial aid files within established deadlines.
- Maintain office productivity and accuracy standards, actively engaging in training sessions to enhance skills and ensure consistent performance.
Education
Bachelor's Degree - International Business
Berkeley College
Woodland Park, NJSkills
- Claims Management
- Policy Analysis
- Claims Resolution
- Database Management
- Microsoft Office
- Law
- Communication
- Problem Solving
- Critical Thinking
- Project Planning
- Training & Development
- Compliance
Personal Information
Title: CLAIMS SPECIALIST
Languages
Spanish
Native or Bilingual
Timeline
Operations Assistant/Dispatcher
Rivas Hotshot
09.2022 - 10.2024
Claims Specialist/Claims Technical Expert
Social Security Administration
05.2014 - 08.2022
Financial Aid Administrator
Berkeley College
05.2008 - 03.2014
Bachelor's Degree - International Business
Berkeley College
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