Accomplished Claims Specialist with a proven track record at the Social Security Administration, adept in claims processing and investigation. Demonstrates exceptional verbal communication and teamwork, ensuring accurate entitlement decisions and policy interpretation. Mentored junior staff, enhancing customer care and operational efficiency. Skilled in both English and Spanish, facilitating clear understanding of complex policies for diverse clients.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Part time employee
National Park Service
04.2021 - 08.2024
Assisting with the park’s interpretive programs and projects
Working at the park visitor center
Event planning for visitors
Create activities for all age groups that visit the park and serve as assistant outreach coordinator in diverse communities.
Clean fish tanks, clean reptile areas
Feed reptiles and make sure they are healthy
Record feeding on excel spreadsheet
Experienced in animal behavior. Animal handling.
Clean government building and vehicles
Lawn mowing and weed wacking
Operate government vehicles and used government purchase cards.
Purchase supplies, fee technician experience.
Claims Specialist
Social Security Administration
02.2016 - 04.2021
Adjudication and authorization of entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA
Developed, investigated, and resolved claims and post-entitlement actions that may involve suspension, resumption, adjustment, or termination of eligibility, or payments
Knowledge of various federal and state laws pertaining to veterans’ benefits, disability, workers compensation, railroad retirement, tax codes, immigration and naturalization, and others having a relationship to SSA programs to make appropriate adjudicative decisions and referrals as needed and as assigned
Review and analyze records request and applying Privacy Act and FOIA policy
Referrals of fraud waste and abuse concerning SSA programs and operations to OIG
Interpret complex SSA policies and practices to individuals, individuals and their representatives, and or individuals and their families
To facilitate the interpretation of the SSA policies and practice to individuals I regularly must write, speak, and read in Spanish and am a certified translator for the SSA
Directly responsible for ensuring the understanding and comprehension of SSA policy to large group of the public
Directly responsible for training progression, customer care, employee etiquette, and serve as a mediator between the junior employee’s and management.
Contact Service Representative
Social Security Administration
04.2014 - 02.2016
Explain technical provisions, elicits relevant facts and resolves problems with payments or eligibility
Provide beneficiaries with information, advice or instructions about eligibility and benefits being paid under retirement, survivors, disability and Medicare insurance programs; the Black Lung program and Supplemental Security Income
Initiate contact with beneficiaries or others to obtain omitted reports and clarify inconsistent or incomplete reports
Investigates and resolves systems-identified discrepancies and questionable situations
Submit Fraud Referrals
Administrative Secretary/Pass coordinator
Training Support Center Great Lakes
08.2011 - 04.2014
Executed the full range of standard positional support,
Provided high-level administrative support by conducting research, preparing statistical reports, handling information requests, and performing clerical functions such as preparing correspondence, receiving visitors, arranging conference calls, and scheduling meetings
Performed appropriate position and division level required duties with proficiency using differing methods, mediums and computerized systems as required.
Duties conform to internal procedures, administrative and quality controls, existing standards and guidelines on confidentiality, personal privacy, operation/information security, and other relevant.
Provide advice to individuals concerned when appointments need to be rescheduled and arranges mutually agreeable time
Receive and control mail routing items directly to appropriate division office
Review outgoing correspondence for required signatures, format, and conformance with procedural instructions
Travel arrangements, types various travel vouchers and reports independently correct and edit technical items for topical reports, news releases, and briefings
Conduct staff inspections to ensure compliance with administrative regulations and procedures.
Process personnel actions.
Review regulations and directives related to administration and military personnel programs, functions, and procedures
Develop plans to provide for integrated administrative services
Applied knowledge of the Command and management principles and regulations, to review and analyze administrative functions, such as personnel, manpower, recordkeeping, training, awards, and other programs
Review and interpret higher headquarters guidance and disseminate to management
Directly responsible for implementation onboarding and exit classes to large groups of sailors
Responsible for informing the sailors on the expectation of the Navy in their current command and for the future.
Personnel Specialist II
Alutiiq
07.2010 - 08.2011
Company Overview: Federal Contractor
Reserve, Retired personnel and newly separated service members
Ensure disbursed payment posts to members pay account
Maintained and originate member's separation worksheets
Scan and file separation worksheets in command database
Created activity and strength loss documents of members
Process extension documents for members extending enlistment contract
Researched delinquent overpayment history of member's and notified the pay clerks
Team player in a group setting to complete retirement/separation closeouts
Prepared and process all reenlistment contracts for members
Prepared and process contract to extend member's current contract
Updated Page 2's to ensure all personal/family information is accurate and up to date
Prepare orders according to NATO regulations
Ensured that all records were up to date when member reenlisted or extended
Entered and verify awards into member's permanent service record
Conferred with departments supervisors to determine progress of work
Responsible for planning, organizing, directing, and supervision
Advised employees of the performance requirements of their positions.
Personnel specialist
U.S Navy
06.2008 - 07.2010
Company Overview: Active Duty Military Service
Aiding in offices combined efforts to maintain the highest levels of customer service by assisting coworkers with their workloads
Routine office receptionist and customer service representative, prepared reports and correspondence, travel and other personnel documents
Applied navy regulations in the preparation of leave records as well as during the verification and processing of the dependency data forms
Utilized military pay computerized systems such as MMPA – Master Military Pay Account and DMO – Defense Military Pay Office
Performed arithmetic computations to compute military pay and allowances
Interpreted and applied regulations and procedures related to military pay and allowances
Active Duty Military Service
Production Coordinator
Broad Ridge co. / ADP
06.2005 - 02.2007
Scheduled and coordinated flow of work within and between departments of manufacturing plant to expedite production
Discussed new hires background, education, training, and job history and successfully identified individual’s skills to determine which occupations they would be the most productive
Reviewed master production schedule and work orders established priorities for specific customer orders, and revised schedule according to work.
Distributed work orders to departments, denoting number, type, and proposed completion date of units to be produced.
Compiled reports concerning progress of work and downtime due to failures of machines and equipment to apprise production-planning personnel of production delays
Maintained inventory of materials and parts needed to complete production.
Education
Attending college
Columbia College
Gurnee
Attending college
Oakton College
Des Plaines
High School or equivalent -
Farragut Career Academy
Chicago
06.2005
Skills
Claims
Claims processing
Claims investigation
Verbal communication
Certification
Criminal Investigations Certificate
Illinois Coaching Certification
CPR/AED certification
References
Steve Housman, SSA/TE at Michigan City FO, 219-983-2005
Mike Ringer, SSA/DM at Durango FO, 1-888-475-0291
Maria Watson, SSA/Regional employee
Raul Romero, U.S Navy OIC assistant, 847-688-5550, raul.a.romero@navy.mil
Christina Lewis, Federal Employee DOD MEPS, Christina.a.lewis@navy.mil
Languages
Spanish
Native or Bilingual
Timeline
Part time employee
National Park Service
04.2021 - 08.2024
Claims Specialist
Social Security Administration
02.2016 - 04.2021
Contact Service Representative
Social Security Administration
04.2014 - 02.2016
Administrative Secretary/Pass coordinator
Training Support Center Great Lakes
08.2011 - 04.2014
Personnel Specialist II
Alutiiq
07.2010 - 08.2011
Personnel specialist
U.S Navy
06.2008 - 07.2010
Production Coordinator
Broad Ridge co. / ADP
06.2005 - 02.2007
Attending college
Columbia College
Attending college
Oakton College
High School or equivalent -
Farragut Career Academy
Criminal Investigations Certificate
Illinois Coaching Certification
CPR/AED certification
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