Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
22
22
years of professional experience
Work History
Insurance Customer Service Representative
Tokio Marine HCC
01.2020 - Current
.
Checked documentation for accuracy and validity on updated systems.
Verified client information by analyzing existing evidence on file.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Maintained confidentiality of patient finances, records and health statuses.
Prepared insurance claim forms or related documents and reviewed for completeness.
Evaluated and settled complex insurance claims in strict timeframes.
Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
Initiated outbound customer calls to review policy reviews and late payments to avoid lapse in coverage.
Directed incoming calls to internal personnel and departments, routing to best-qualified department.
Investigated and resolved customer inquiries and complaints quickly.
Responded proactively and positively to rapid change.
Exhibited high energy and professionalism when dealing with clients and staff.
Delivered prompt service to prioritize customer needs.
Met customer call guidelines for service levels, handle time and productivity.
Responded to customer requests, offering excellent support and tailored recommendations to address needs.
Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Cross-trained and provided back up for customer service managers.
Case Manager
Childrens Home Society
12.2019 - 12.2020
Provides comprehensive data updates to Program Manager regarding status of screening/assessment activity.
Managed caseload of 25+ children in welfare system to provide comprehensive, community-based care.
Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
Managed support services and fostered communication among social workers, therapists, hospital staff and patients.
Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
Collaborated with external agencies to meet educational and transitional needs of students.
Educated patients and loved ones about different treatment options and outside care approaches to reduce burden on hospital resources.
Developed positive relationships with parents to foster communication and encourage involvement for student growth.
Evaluated IEP for compliance with state and federal requirements regulations and rectified non-compliance issues immediately.
Monitored student progress and reviewed and revised IEP to meet emerging student needs.
Claims Adjuster
Liberty Mutual
05.2016 - 12.2019
Apply critical thinking and problem-solving skills to research, troubleshoot, and walk clients through system to provide solutions
Communicate effectively with clients using phone, text, or email
Establish customer relationships and follow up with customers, as needed
Schedule appointments for estimates and/or repairs, identify customer needs, and provide options
Follow up on pending issues seeking resolution
Provide thorough, accurate and ethical customer support to clients
Develop and maintain strong relationships with clients and team members
Respond to emails in timely manner creating effortless experience for client
Serve as Mentor on Liberty Mutual Mentor Team mentoring New Trainees during their “Nesting” period.
Liaised between account holders and various departments.
Listened attentively to client feedback and worked with product development team to introduce new services.
Case Management Specialist
Aon Hewitt
10.2014 - 05.2016
Demonstrated “I CAN HELP ATTITUDE”
Excellent writing skills, concise and accurately constructed correspondence
Detail oriented with ability to manage time effectively as hourly production is measured accordingly
Sustain productivity and quality targets
Provided one call resolution to each problem that arose
Review detailed medical records, itineraries and other documentation
Proactive work to resolve claims as expeditiously as possible; decisions are made based on authority levels, policies and documented procedures.
Answered questions about eligibility determinations and plan options.
Processed enrollment paperwork and benefits forms.
Payment Specialist
Chase Bank
04.2001 - 10.2014
Responded to customer inquiry calls, quickly assessing consumer needs and problems in order to deliver ideal solution
Ability to multitask different screens using dual monitors
Provided One shop stop addressing all customer concerns
Exceeded monthly goals that were required
Spoke with business owners to service credit cards and payment issues
Engaged customers about their benefits by asking probing questions
Drove dispute resolutions using effective problem-solving and by guiding mutual understanding of opposing viewpoints.
Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
Maintained energy and enthusiasm in fast-paced environment.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Offered friendly and efficient service to customers, handled challenging situations with ease.
Education
Bachelor of Applied Science - Health Service Administration, Health Service Information
University of Central Florida
Orlando, FL
08.2014
Associate of Applied Arts - Health Service Administration
Seminole State College of Florida
Sanford, FL
12.2010
Skills
Excellent verbal and written communication skills
Case Management Tracking
Multitasking and Organization
MS Office
Operational Standards
Data Entry and Analysis
Conflict Resolution
Superb active listening skills
Implementation and configuration
Issue resolution
Able to establish rapport and create positive customer experience
Capable of engaging customers easily
Medical terminology knowledge
Professional telephone demeanor
Timeline
Insurance Customer Service Representative
Tokio Marine HCC
01.2020 - Current
Case Manager
Childrens Home Society
12.2019 - 12.2020
Claims Adjuster
Liberty Mutual
05.2016 - 12.2019
Case Management Specialist
Aon Hewitt
10.2014 - 05.2016
Payment Specialist
Chase Bank
04.2001 - 10.2014
Bachelor of Applied Science - Health Service Administration, Health Service Information
University of Central Florida
Associate of Applied Arts - Health Service Administration
Seminole State College of Florida
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