Minerva Rivera
Elizabeth,NJ
Summary
Proven Claims Representative with a track record of enhancing customer satisfaction and maintaining regulatory compliance at the New York State Insurance Fund. Skilled in Insurance Claims Review and exceptional interpersonal communication, adept at processing high volumes of claims and improving department efficiency. Demonstrated ability to manage peak season workloads, achieving positive outcomes through teamwork and continuous professional development.
Overview
40
40
years of professional experience
Work History
Claims Representative
New York State Insurance Fund
02.1977 - 11.2016
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Provided exceptional customer service by addressing concerns, answering questions, and explaining complex policy information to clients.
- Actively contributed ideas during team meetings aimed at enhancing overall department efficiency and effectiveness.
- Adhered to strict confidentiality guidelines when handling sensitive client information, maintaining trust among clients and colleagues alike.
- Developed strong working relationships with clients, adjusters, and other stakeholders in the claims process by maintaining open lines of communication and providing consistent updates on claim status.
- Continuously updated skills through professional development training opportunities, leading to improved job performance.
- Achieved positive results under pressure by successfully managing large workloads during peak seasons without sacrificing quality or attention to detail.
- I also scheduled audit appointments in our field auditors appointment schedules.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Processed and recorded new policies and claims.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Confirmed appointments with our policy holders.
Education
High School Diploma -
Seward Park High School
New York, NY05.1972
Skills
- Microsoft Office
- Insurance Claims Review
- Claims Investigation
- Time Management
- Interpersonal Communication
- Accident Investigations
- Documentation Review
- Workers Compensation
- Customer Service
- Teamwork and Collaboration
- Records Management
- Excellent administrative abilities
Languages
Spanish
Professional Working
English
Professional Working
Timeline
Claims Representative
New York State Insurance Fund
02.1977 - 11.2016
High School Diploma -
Seward Park High School
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