Sheila Martinez
Lakeland,FL
Summary
Dedicated professional with a proven track record in customer service and training. Demonstrated ability to guide teams and enhance processes, ensuring high levels of client engagement and support.
Overview
37
37
years of professional experience
1
1
Certification
Work History
Agent Services Representative II/Desk Examiner
Universal Property & Casualty Insurance
Ft. Lauderdale, FL 33309
10.2016 - 11.2023
- Developed and implemented effective communication strategies between agents and underwriting teams to improve overall response times.
- Cultivated and sustained in-depth expertise in insurance products to empower agents and insureds.
- Coordinated efforts with cross-functional teams to swiftly resolve inquiries from agents and insured parties, ensuring optimal satisfaction outcomes.
- Communicated essential compliance updates and policy management best practices to insured clients and agents to ensure adherence.
- Executed process enhancements to optimize documentation submissions, improving efficiency for agents and insureds.
- Guided junior representatives to enhance professional development and elevate team performance standards.
- Engaged with agents and insureds through inbound phone calls, emails, and chat to deliver informed product and service recommendations.
- Enhanced customer satisfaction through active listening and problem-solving strategies, supporting claims and underwriting operations.
- Maintained adherence to regulatory standards by actively researching and integrating industry trends and best practices in agent services and property & casualty claims management.
- Facilitated daily interactions with internal and external customers, ensuring world-class service delivery and support.
- Maintained precise documentation of agent interactions to support informed decision-making within the department.
- Contributed to ongoing team discussions aimed at optimizing processes and improving service delivery in agent services, claims operations, and underwriting.
- Addressed complex issues effectively by engaging relevant stakeholders to facilitate prompt resolutions.
- Verified and updated department reports, ensuring accurate contact information and enrollment details.
- Directed cross-functional collaboration to create and apply innovative strategies targeting client retention and business expansion.
- Surpassed established monthly goals through strategic planning and execution.
- Managed competing priorities to ensure timely and high-quality support for agents and customers.
- Fostered strong client relationships through customized strategies aimed at improving retention.
- Delivered strategic assistance to agents, fostering an environment of high productivity and achievement.
- Delivered exceptional support by addressing customer requests and providing tailored recommendations.
- Exhibited enthusiasm and professionalism while collaborating with clients and team members.
- Adhered to customer call guidelines to optimize service levels and manage handle time effectively.
- Delivered comprehensive guidance to customers regarding billing payment processing and support procedures, ensuring clarity and adherence.
- Embraced rapid changes with a proactive and positive approach to support team objectives.
- Cultivated strong client relationships, establishing a reputation for surpassing service standards.
- Analyzed and rectified discrepancies and errors in customer accounts.
- Promoted operational best practices to drive efficiency and elevate team productivity.
- Managed inter-departmental escalations to support customer retention initiatives.
- Enhanced customer retention by connecting insureds with agents upon identifying opportunities for policy discounts and additional coverage.
Claims Representative
Federated National
Sunrise, FL 33023
03.2016 - 05.2016
- Managed complex claims processes, ensuring compliance with company policies and state regulations for FL, TX, and NC.
- Analyzed claim submissions for accuracy, identifying discrepancies and initiating corrective actions.
- Mentored junior representatives, fostering skill development and promoting best practices in claims management.
- Conducted regular audits of claim files to ensure adherence to internal controls and quality standards.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Developed strong relationships with clients, facilitating trust and open communication during the claims process.
- Negotiated favorable settlements with claimants, resulting in cost savings for the company.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Served as a subject matter expert on specialized claims, providing guidance and support to other team members when needed.
- Developed in-depth understanding of insurance policies and procedures.
- Provided exceptional customer service, addressing concerns and resolving issues promptly.
- Delivered personalized customer service, addressing policyholder concerns and clarifying coverage details.
- Fostered positive relationships with policyholders, contributing to higher retention rates.
- Conducted detailed investigations into suspicious claims, reducing instances of fraud.
- Leveraged technology to automate routine tasks, allowing more focus on complex claim investigations.
- Maintained up-to-date knowledge of regulatory changes, ensuring company compliance and minimizing legal risks.
- Maintained confidentiality of patient finances, records, and health statuses.
- Checked documentation for accuracy and validity on updated systems.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Collaborated with cross-functional teams to resolve escalated claims issues, enhancing customer satisfaction.
- Trained new team members on claims procedures and software systems to streamline onboarding processes.
Sr Claims Representative
Allstate Insurance Group
Margate, FL 33063
09.1986 - 07.2015
- Oversaw complex claims processes, ensuring adherence to state regulations and company policies.
- Directed training sessions for new representatives, boosting team performance and knowledge retention.
- Analyzed claim documentation to establish validity and identify potential fraud risks.
- Cultivated a supportive environment for junior representatives, emphasizing professional growth and adherence to best practices.
- Evaluated complex claims data to identify trends and recommend strategic improvements.
- Engaged with legal and medical experts to collect critical data necessary for thorough claim evaluations.
- Facilitated timely and accurate resolution of claims disputes to enhance customer satisfaction.
- Guided new hires in understanding company policies and procedures to enhance team productivity.
- Administered a large volume of cases, maintaining rigorous deadlines and achieving dependable results under demanding conditions.
- Selected and managed expert witnesses and litigation managers for investigations.
- Analyzed existing workflows and implemented improvements to elevate efficiency in claim handling operations.
Education
No Degree - Business Administration
Barry University
Miami, FLSkills
- Strong negotiation skills
- Call center experience
- Data entry proficiency
- Complaint handling
- Client needs assessment
- Financial transactions
- Escalation management
- Technical aptitude
- Up-selling strategies
- Customer service
- Problem-solving
- Adaptability and flexibility
- Verbal and written communication
- Problem resolution
- Data entry
Accomplishments
- Telephone Service - Professionally processed 80+ calls per day, providing information and service to ensure customer satisfaction.
- Promoted products and encouraged customers to upgrade their existing product plans.
- Monetary Transactions - Handled cash, check, credit and automatic debit card transactions with 100% accuracy.
- Conflict Resolution - Accountable for managing customer account inquiries, accurately delivering information to ensure the resolution of product/service issues and customer satisfaction.
- Achieved 99.8 percent quality compliance consistently per management evaluations; based on phone call monitoring, system documentation, training evaluations and feedback of my skills, peer feedback, and Google Reviews.
- Resolved multiple processing deficiencies while collaborating with team members on better ways to handle volume, quality, to enhance the customer experience.
- Used Microsoft Excel to develop tracking spreadsheets for processing of documents by individual colleagues, enabled management to view the quantity as well as quality. These spread sheets allowed management to coach individual processors on quality, quantity and timeliness of handling assigned task. This enabled management to share with multiple departments for process and compliance management and to further ensure positive customer experiences.
Certification
- Licensed 6-20 Adjuster All Lines-Since 1999
- Licensed 20-44 Personal Lines Agent- Since 2019.
Languages
English
Native or Bilingual
Interests
- Exploring various forms of art, such as scrapbooking, Paper art and DIY projects to nurture creativity and personal growth
- Fundraising Events to include participating Big Brothers and Big Sisters, volunteering at an elementary school to work with students who were academically struggling, was the office liaison for March of Dimes on numerous occasions Successfully led internal employees on donation food drives, catastrophic relief donations, and funds and services for an employee's son who required a lung transplant at an early age
- Community Cleanup- Participated on several occasion's for local park, school and beach clean up efforts Volunteered with Habitat for Humanity to help with constructing affordable living for those in the community
Timeline
Agent Services Representative II/Desk Examiner
Universal Property & Casualty Insurance
10.2016 - 11.2023
Claims Representative
Federated National
03.2016 - 05.2016
Sr Claims Representative
Allstate Insurance Group
09.1986 - 07.2015
No Degree - Business Administration
Barry University
Allstate Insurance Company-Distinguished Performance Award 2 Times (Top 3 Percent of Employees)
I was honored with receiving multiple awards throughout my career with Allstate Insurance Corporation. The most prestigious award is the Distinguished Performance Award which is awarded on a yearly basis. I was delighted to have won this award on two seperate occassions.
The local management team recognized my self motivated willingness to learn and grow within the different roles in the claims department. This was accomplished by attending workshops with other professionals in the insurance business, mentoring agent partners on collaborative efforts to assist the agent partner's on providing a direct contact for their customers with inquiries and concerns. This effort also allowed me to experience the agency handling of day to day activities and offer input. Showcased my professional and ethical handling of escalated concerns, worked with management to resolve these issues as well for a quick, speedy and fair resolution. My customer service to both internal and external customers was often recognized via surveys from external customers and internal observations.
Lastly, I was recogized on multiple occassions for leading employee involvement in external and internal fund raising raising and employee engagement awards. These opportunities, allowed me to grow as an employee and personally. I simply was embracing each opportunity as another opportunity to help another achieve their goals. This was incredibly awarding and humbling to myself.