TWANDA SURELLER
Tampa,FL
Summary
Detail-oriented administrative professional with extensive experience in high-volume GTE call center environments, consistently delivering exceptional clerical and operational support. Recognized for strong decision-making abilities and a commitment to outstanding customer service, contributing to improved client satisfaction. Possesses excellent communication skills and a proven track record in relationship building, ensuring efficient task management with minimal oversight. Aiming to leverage expertise in a dynamic role that emphasizes operational excellence and team collaboration.
Overview
22
22
years of professional experience
Work History
Background Investigator
Command Investigations
Lake Mary, FL
06.2022 - 08.2022
- Conduct thorough detailed and in-depth background and social media investigations through online research on injured workers, used private and public database services, another other related investigative tasks
- Utilized SharePoint for medical templates and reporting dashboards, and CRM for managing claim disclaimers, client details, and medical records.
- Set up medical canvasses on SharePoint templates and established contact with 50+ listed providers, obtaining detailed medical histories for injured workers in 90% of cases
- Transferred claimant data onto a disclaimer and a letter for 300+ cases, ensuring accuracy and completeness
Claims Operations Professional Associate
AIG Global Investigative Services ISD
Tampa, FL
09.2013 - 03.2022
- Governed the allocation of AIG and offline referrals for internal (SIU) investigators, claims adjusters and panel vendors, ensuring immediate investigation and enhancing the efficiency of the investigative process
- Handled a significant portion of Foreign National referrals, maintaining clear communication with staff, claimants, and vendors
- Maintained meticulous records by saving and uploading correspondence, obtained records retrieval, invoices, approved budgets, extensions, and finalized billing information into the system
- Handle incoming/outgoing communication, research referrals and medical reports, escalate complaints, and generated EOM reports
- Organized ISD case counts per investigators, ensuring optimal workload distribution and case resolution efficiency
- Completed required online courses and Continuing Education Units (CEU) classes
- Demonstrated flexibility by providing coverage for other Associates' desks during their scheduled off periods, maintaining uninterrupted workflow
Claims Assistant
AIG Domestic Claims
Tampa, FL
09.2000 - 09.2013
- Generated EOM Pending and EOM Closed reports, producing reserves and voided checks, entry-level claims handling on Medical-Only cases, distributing them electronically to managers and adjusters for informed decision-making
- Compiled and distributed daily new claims filings reports to all Claims Assistants, ensuring seamless filing and mailing processes, guaranteeing efficient claims management
- Administered daily inbound/outbound communication, resolved claimant inquiries, with focused on managing complaints effectively, enhancing customer satisfaction
- Handled EDI compliance while ensuring seamless electronic communication
- Coordinated 20+ appointments daily, facilitated transportation, translations, obtained records retrieval, provided essential demographic details to healthcare providers, ensuring smooth coordination of medical services for the injured worker
- Processed and authorization letters, efficiently managed pharmacy log requests, ensuring accurate record-keeping and claims processing
- Handled and resolved payment issues with P&I on indemnity payments, issued stop payments, reissued checks when necessary, ensuring compliance and accuracy in financial transactions
- Provided valuable mentorship to claims assistants, fostering professional growth
Education
Insurance And Risk Management
AE21 Online Adjuster Training And Licensing
Lutz, FL01-2015
Administration Training - Educational Administration
Hillsborough Community College
Tampa, FL02-1995
GED -
Hillsborough Adult & Education Center
Tampa, FL06-1992
Skills
- Time Management
- Claims Handling
- Technology Proficiency
- Regulatory Compliance
- Negotiation Skills
- Empathy and Professionalism
- Continuous Learning
- Claims processing
- Medical record retrieval
- Attention to detail
- Customer service
- Time management
- Problem solving
- Team collaboration
- Effective communication
- Conflict resolution
- Inbound phone call management
- Call controlling
- Logging call information
- Database research
Timeline
Background Investigator
Command Investigations
06.2022 - 08.2022
Claims Operations Professional Associate
AIG Global Investigative Services ISD
09.2013 - 03.2022
Claims Assistant
AIG Domestic Claims
09.2000 - 09.2013
Insurance And Risk Management
AE21 Online Adjuster Training And Licensing
Administration Training - Educational Administration
Hillsborough Community College
GED -
Hillsborough Adult & Education Center
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