Rocio Cervantes
Chesterton,IN
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Summary
Experienced Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 18 years of experience and willingness to take on any challenge.
Overview
15
15
years of professional experience
1
1
Language
Work History
Bilingual Claims Specialist
Social Security Adminstration
Merrillville, IN
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
Merrillville, IN
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
Chesterton, IN
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.
Education
Medical Administration - Human Resources Management
09.2015
Skills
- Constructive Feedback
- Monitoring
- Claims
- Microsoft Office
- Exceptional Recordkeeping Abilities
- Time Management
- Work Organizing and Prioritizing
- Negotiation Leadership
- Complex Problem-Solving
- Personal Data Evaluation
- Speaking
- Reading Comprehension
- Production Goals
- Great Mathematical Skills
- Special Handling
- Writing
- Payment and Investigation Escalations
- Form Preparation
- Documentation Review
- Claim Processing System Software
- Past Due Balance Management
- Large-Sum Computations
- Microsoft Access
- Forms Validation
- Database Updates
- Operation Monitoring
- Secure Data Practices
- Electronics Knowledge
Languages
Spanish
Native or Bilingual
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Bilingual Claims Specialist - Social Security Adminstration
09.2014 - Current
Center Manager - Advance America
10.2010 - 09.2014
Assistant Branch Supervisor - TCF National Bank
04.2008 - 10.2010
Ashford University - Medical Administration , Human Resources Management