Shuhei Iturriaga
Scarsdale,United States
Summary
Claims Examiner with over 7 years of experience in claims examination and 10 years of customer service. Demonstrates exceptional skills in team collaboration and customer satisfaction, driving improvements in service quality. Committed to fostering a supportive environment and leveraging analytical expertise to innovate claims management processes.
Overview
11
11
years of professional experience
Work History
AMS Claims Examiner II
Reliance Matrix
10.2018 - Current
- Ensure accurate coding of all system fields with correct financial, diagnosis, and duration data
- Coordinate with cross-functional teams to ensure smooth transitions for claims and facilitate timely return to work
- Adhere to compliance protocols, departmental procedures, and Unfair Claims Practices regulations
- Proactively engage in training to stay current with claims management
- Assisted in the development of training materials for new Claims Examiners, fostering a supportive learning environment.
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
Claims Examiner
Reliance Matrix
07.2017 - 10.2018
- Interpret and administer contract provisions related to eligibility, duration, and claims processing
- Investigated and provided resolutions to claims within specified departmental and regulatory guidelines
- Accurately processed claims, ensuring compliance with eligibility, duration, and financial guidelines
- Worked with various departments to ensure timely and accurate claims resolution
- Contributed to departmental goals focused on improving customer service, quality, and performance outcomes
Back-up Operations Supervisor / Head Teller
Citibank
10.2013 - 06.2017
- Led teller operations, enhancing accuracy and customer satisfaction through streamlined processes
- Managed cash flow, reducing discrepancies and improving audit compliance with precise oversight
- Trained staff, fostering a collaborative environment that boosted team efficiency and morale
- Resolved complex customer issues, ensuring swift solutions and maintaining high service standards
Education
Bachelor of Arts - Psychology
St. John's University-New York
Jamaica, NY05.2013
Skills
- Customer Service
- Regulatory Compliance
- Conflict Resolution
- Data verification
Timeline
AMS Claims Examiner II
Reliance Matrix
10.2018 - Current
Claims Examiner
Reliance Matrix
07.2017 - 10.2018
Back-up Operations Supervisor / Head Teller
Citibank
10.2013 - 06.2017
Bachelor of Arts - Psychology
St. John's University-New York
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