PATRICIA HERNANDEZ
Sheboygan,WI
Summary
Detail-oriented insurance professional skilled in operations, data processing, quality assurance, and documentation. Strong knowledge of customer workflows, data accuracy, and company Processes. Proficient in Excel, CRM/database, ACMS,Next Gen, Loss Entry, Microsoft Teams, and remote collaboration and Business Systems to drive process improvement
Overview
9
9
years of professional experience
Work History
Customer Service Representative
Acuity Mutual Insurance
Sheboygan, Wisconsin
01.2025 - Current
- Processed insurance claims efficiently and accurately for various policyholders.
- Intake claim infor
- Support insurance operations by reviewing policies, identifying discrepancies, and helping resolve client and workflow issues with attention to detail.
- Investigated and resolved discrepancies related to claim payments or denials.
- Collaborated with adjusters to clarify claim details and expedite resolutions. to clarify details of claims and expedite resolutions.
- Handle administrative and insurance information with a high level of confidentiality, accuracy, and professionalism.
- Apply customer-service and claims-support knowledge to understand operational needs and communicate effectively with internal stakeholders.
- Maintained detailed records of claims and correspondence in management systems.
- Process insurance-related documents and data using Microsoft Excel and Word, maintaining accuracy and adherence to established business procedures.
- Collaborated with team members and other departments through Microsoft Teams and Outlook to communicate issues, follow up on requests, and support timely resolution.
- Work independently in a remote environment while managing multiple priorities, deadlines, and business-system tasks.
- Initiated and closed glass and towing claims from start to finish issuing payments or denials depending on policy and coverages
- Trained new staff on claims processing protocols and best practices.
- Provided feedback on procedures to enhance operational efficiency within the department.
- Compiled statistical information for use in preparing reports that analyze trends in claims processing.
- Collaborated with team members to improve workflow and service delivery standards.
- Assisted customers in understanding their coverage options and claim procedures.
Bilingual medicall Collection Specialist
Americollect
Manitowoc, WI
01.2022 - 01.2024
- Used bilingual English/Spanish communication to resolve issues, clarify information, and provide professional support through calls and email.
- Tracked customer interactions and account information to ensure consistent workflows and accurate documentation.
- Communicated with clients via phone and email regarding payment arrangements.
- Maintained and updated customer/account information in internal databases and Microsoft Excel, emphasizing data accuracy and completeness.
- Oversaw customer accounts by tracking payment statuses and ensuring timely collections. to ensure timely collection of outstanding balances.
- Engaged with clients through phone and email to discuss payment arrangements. via phone and email regarding payment arrangements.
- Analyzed account histories to identify payment behavior patterns that informed collection strategies.
- Collaborated with team members to enhance collection strategies and streamline processes.
- Educated clients on billing procedures and payment options available to them.
- Maintained compliance with federal regulations governing debt collection practices.
- Assisted customers with financial hardship by offering alternative payment plans or other solutions that would benefit both parties.
- Consistently met daily productivity expectations while maintaining accuracy, confidentiality, and quality standards.
Production Associate
Kohler Company
Kohler, WI
01.2018 - 01.2020
- Ensured adherence to quality-control standards and operating procedures in high-volume environment to maintain product integrity.
- Collaborated with team members to achieve production goals and uphold quality standards, enhancing workflow efficiency.
- Exhibited reliability, adaptability, precision, and attention to detail in process-driven operations to support overall productivity.
Education
General Studies -
Northcentral Technical College
Wausau, WIHigh School Diploma -
D.C. Everest High School
Schofield, WISkills
- Claims management
- Claims processing
- Claims data analysis
- Claims filing
- Insurance processing
- Business Process Support
- Process improvement
- Workflow management
- Process documentation
- Process mapping
- Report generation
- Excel
- Microsoft Excel
- Insurance software
- Outlook
- Teams
- Word
- Requirements thinking
- Stakeholder needs
- Problem solving
- Cross-functional collaboration
- Remote teamwork
- Customer service
- Bilingual English/Spanish
- ACMS
- NEXT GEN
- LOSS ENTRY
Career development
Job shadows
Process flow review
Personal development
TRAINING
Timeline
Customer Service Representative
Acuity Mutual Insurance
01.2025 - Current
Bilingual medicall Collection Specialist
Americollect
01.2022 - 01.2024
Production Associate
Kohler Company
01.2018 - 01.2020
General Studies -
Northcentral Technical College
High School Diploma -
D.C. Everest High School