Results-driven professional with strong communication, organizational, and interpersonal skills that enhance collaboration and efficiency. Excels in challenging environments with minimal supervision. Bilingual in Spanish, effectively resolving customer issues and improving satisfaction.
Overview
26
26
years of professional experience
Work History
Claims Adjudicator Investigator II
Texas Workforce Commission
Fort Worth
12.2017 - Current
Reviewed and processed unemployment insurance claims, analyzing documentation to determine benefit eligibility.
Conducted thorough research and data verification for accurate claim adjudication.
Identified discrepancies and negotiated settlements based on regulatory findings.
Managed caseloads and workflows, prioritizing tasks for timely resolution using claims processing software.
Provided exceptional customer service by addressing claimant inquiries and resolving disputes effectively.
Maintained comprehensive claim documentation in compliance with company policies and state guidelines.
Collaborated with internal teams and external representatives to support investigations and decision-making.
Familiarized with FMLA leave and ADA laws to assess claim eligibility efficiently.
Administrative Assistant / HR Admin. / Personal Supervisor
Employbridge
06.2015 - 01.2016
Administered new hire orientations and drug screens, completing I-9's using E-Verify to ensure compliance.
Completed timecards and payroll for all associates. Set up direct deposit/pay cards using ADP, Kronos, PeopleSoft and many other systems
Greeted clients and employees at reception, fostering a welcoming environment.
Answer all inbound calls/ faxes and file all necessary paperwork
Created weekly invoices for all vendors using Microsoft Excel, facilitating timely payments.
Attended weekly on-site trainings and translated for our new hires for multiple vendors.
Familiar with Osha Regulations
Customer Care Representative / Advance Tech Support / Special Device Group / Tier 3 / Subject Matter Expert (SME)
Sprint PCS
07.2006 - 03.2014
Provide effective and timely resolution of a variety of customer inquiries, resulting in satisfaction and loyalty of Sprint's corporate clients.
Technical support for various wireless devices including: Apple, Windows Mobile, Android, Blackberry, and connection cards.
Analyze, troubleshoot and resolve various device and network issues.
Determine the root cause of device issues and determine if the concern is the result of hardware, operating systems, application programs or network failure.
Troubleshoot and resolve service impairments and be able to effectively communicate to customers exactly what the issue is in terms they can understand.
Coordinated problem-solving efforts between customers and field service personnel, ensuring timely resolution of product issues.
Diagnoses mechanical, hardware, software and systems failures, using established Sprint procedures - some problem solving involves collaboration with the vendor.
Identified cost-effective repairs and resolutions to minimize customer downtime, optimizing service delivery.
Delivered client support for new data products and service initiatives, enhancing user experience and adoption.
Customer Service Rep / Service and Repair Tech
The Customer Center - Sprint Authorized Retailer
06.2004 - 07.2006
Diagnoses mechanical, hardware, software and systems failures, using established Sprint procedures - some problem solving involve collaboration with the vendor.
Suggest and educate the consumer on devices, accessories, upgrade and plan options, and other enhanced features.
Involved with repairing computers or electrical equipment, software/hardware.
Computer navigation and abilities - quickly and efficiently navigating multiple screens.
Multitasking - simultaneous listening and typing.
Complete research of customer accounts and billing issues.
Interacts with the customer to handle a variety of functions.
Pharmacy Tech
Freedom Pharmacy
03.2003 - 04.2004
Swiftly and correctly calculate dosages and dispense medications.
Prepared prescription labels and fill prescriptions for approval by pharmacists.
Take phone calls and provide information.
Assist customers by responding to questions and problems.
Receive and stock incoming supplies and maintain inventory.
Pharmacy Tech / Cashier
Walgreens
11.2000 - 12.2001
Maintained accurate records of prescribed drugs sold to patients to support effective pharmacy operations.
Tracked drug inventory levels to ensure stock availability and minimize shortages.
Stored vaccines in temperature-controlled areas to preserve safety and efficacy for patient use.
Education
Diploma -
Master's Learning Institute
Merkel, TX
Skills
Data verification
Regulatory compliance
Research verification
Data verification
Data analysis
Customer management
Customer service
Customer management
Timeline
Claims Adjudicator Investigator II
Texas Workforce Commission
12.2017 - Current
Administrative Assistant / HR Admin. / Personal Supervisor
Employbridge
06.2015 - 01.2016
Customer Care Representative / Advance Tech Support / Special Device Group / Tier 3 / Subject Matter Expert (SME)