Rocio Cervantes

Work History

Bilingual Claims Specialist

Social Security Adminstration

09.2014 - Current

Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Followed up with customers on unresolved issues.
Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
Conducted full claim investigations and reported updates and legal actions.
Escalated files with significant indemnity exposure to supervisor for further investigation.
Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
Checked documentation for accuracy and validity on updated systems.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Prepared insurance claim forms or related documents and reviewed for completeness.
Posted payments to accounts and maintained records.
Generated, posted and attached information to claim files.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Processed and recorded new policies and claims.
Verified client information by analyzing existing evidence on file.
Reviewed outstanding requests and redirected workloads to complete projects on time.
Communicated effectively with staff members of operations, finance and clinical departments.

Center Manager

Advance America

10.2010 - 09.2014

Managed work and performance of more than Number employees.
Checked facility, employee work and service levels to maintain compliance with company and industry standards.
Processed payroll for over Number employees as part of sound human resources and financial management strategies.
Introduced new methods, practices, and systems to reduce turnaround time.
Prepared annual budgets with controls to prevent overages.
Applied performance data to evaluate and improve operations, target current business conditions and forecast needs.
Evaluated and enhanced Area of expertise programs to strengthen operations.
Interacted well with customers to build connections and nurture relationships.
Trained new employees on proper protocols and customer service standards.
Trained and guided team members to maintain high productivity and performance metrics.
Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
Assisted in recruiting, hiring and training of team members.
Scheduled employees for shifts, taking into account customer traffic and employee strengths.
Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
Managed purchasing, sales, marketing and customer account operations efficiently.
Monitored daily cash discrepancies, inventory shrinkage and drive-off.
Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
Reported issues to higher management with great detail.
Implemented business strategies, increasing revenue and effectively targeting new markets.
Supervised creation of exciting merchandise displays to catch attention of store customers.
Mitigated business risks by working closely with staff members and assessing performance.
Identified and qualified customer needs and negotiated and closed profitable projects with high success rate.
Reduced financial inconsistencies while assessing and verifying billing invoices and expense reports.
Updated and resolved incidents and managed accessorial charges objectively while maximizing profit.

Assistant Branch Supervisor

TCF National Bank

04.2008 - 10.2010

Maintained scheduling for main branch to keep shifts appropriately staffed.
Collaborated with other supervisors to coordinate activities of individual team members and departments.
Set schedule for tellers and customer service representatives.
Delivered product and service quality and inspired team members to reach and maintain department goals and objectives.
Oversaw opening and closing of branch and monitored overdrafts, wire transfers, collections and stop payment orders.
Executed extensive variety of customer transactions according to institutional policy and procedures.
Motivated, trained and disciplined employees to meet performance benchmarks.
Assigned job roles and oversaw performance.
Assisted front-line staff with handling difficulties, resolving problems and managing large transactions.
Complied with established internal controls and policies.
Performed banking, business administration and financial tasks to guarantee five-star service for clients.
Prepared internal and regulatory financial reports, balance sheets and income statements.
Developed strategic plans for day-to-day financial operations.
Established internal audit procedures to validate and improve accuracy of financial reporting.
Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
Utilized financial software to prepare consolidated financial statements.
Established and checked coding procedures, monitored reports and updated internal files.
Improved overall financial reporting by streamlining control processes and reporting structures.
Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
Designed and maintained financial models to identify and measure risks.

Summary

Overview

Work History

Bilingual Claims Specialist

Center Manager

Assistant Branch Supervisor

Education

Medical Administration - Human Resources Management

Skills

Languages

Work Availability

Timeline

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