VENESTA SANCHA BELL
Summary
- 9 plus years experience in service delivery, training, coaching, transition /relocation services, planning, Benefit enrollment and Claims processing
- Strong organizational skills with the ability to manage projects to completion
- Familiar with standard operating procedures and accountability policies in the evaluation process and when making recommendations for improvement
- Analysis of reports/documents to present both written and oral recommendations, taking into consideration the wide range of factors and requirements which affect clients and the service delivery process
- Federal agency experience and the ability navigating organizational bureaucracy
- Comfortable in fast-paced, high-stress environments requiring attention to detail
- Ability to meet deadlines and quick adaptation to constantly changing priorities
- Ability to research issues, laws, policies and procedures and community resources in order to report findings or advise depending on the nature of the request
Overview
22
22
years of professional experience
Work History
Claims Specialist
Social Security Administration
LACEY , WASHINGTON
01.2023 - Current
- Reviews and analyze claims to determine eligibility and process until complete . Mail documents associated with each claim.
- Explains the rules and procedures for each type of benefit
- Investigates complex or high-value claims to identify discrepancies and fraud indicators.
- Researches and review state medical determinations necessary for appeals and other inquiries.
- Processes payments for valid claims according to established policy and procedures.
- Facilitates communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Assists with filing appeals on denied claims or the client was provided with the requisite forms to appeal the denial.
- Compiles data from multiple sources for reporting purposes.
- Advises management on potential changes that arise as it pertains to processing claims and policy updates and makes the necessary modifications as required. .
- Maintains detailed records of all claim activities including notes about conversations with claimants or representatives.
- Provides customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Evaluates financial information provided by claimants in order to process claims quickly and accurately.
- Collaborates with other departments within the organization to resolve issues related to claims processing and with other agencies as needed.
- Resolves claims by approving or denying documentation, calculating benefits due and determining compensation for all claimants involved.
- Processes claims for payment or forwarded to appropriate personnel for further investigation
- Precisely calculates benefit amounts, overpayments, refunds and underpayments due by reviewing multiple systems.
- Handles billing inquiries for medicare part B and also processed insured and uninsured medicare hospital and medical insurance claims.
- Serves as subject matter expert for Retirement, Disability Insurance, Survivor's, Medicare and Supplemental Security Income.
- Collects payments and processes receipts for services due such as outstanding payments for medicare part B.
- Resolves claims discrepancies and third party requests for records and other information.
Service Representative
Social Security Administration
Olympia, WA
07.2014 - 01.2023
- Skill in listening and communicating to address issues that are sensitive in nature and to convey program information to individuals with respect and courtesy.
- Experience drafting professional written correspondence to convey actions taken or actions to be taken in a clear, concise, and timely manner.
- Ability to work independently and with others to achieve set goals in a professional manner.
- Ability to multitask by completing the following actions with the client: listening, researching and interpreting policy, navigating multiple systems, organizing and gathering, prioritizing and communicating the information to the client.
- Reviews policies and law to advise clients and stakeholders about the applicability or suitability of programs.
- Knowledge of laws, regulations, policies, and procedures applicable to each type of benefit payable to respond to questions, resolve complex issues and to make the appropriate referrals.
- Knowledge of other Federal and State Agencies and some of the services provided to better serve clients and make the appropriate referrals as needed.
- Identifies the need for social services and makes the appropriate referrals to private nonprofits or other government agencies.
- Reviews the respective calendars to establish appointments for benefits provided such as: Retirement, Medicare, Disability and Supplemental Security Income.
- Develops and resolves discrepancies in earnings and determines amounts to be posted to one’s earnings record.
- Ability to process Social Security cards with applicable documents for example: State Identification or Department of Homeland Security work authorization documents.
- Ability to resolve issues that may arise on the E-Verify website to provide confirmation to potential employers.
- Mentor to new employees, to provide support, to ensure that the organizational culture is understood while following policy to address each action in a timely and efficient manner.
- Ensuring that the mentee completes the desired training path according to policy and provides the supervisor with feedback on performance and actions to be taken to meet desired goals.
- Alternate remittance clerk, ensures that checks received are processed correctly and that credit and debit card transactions processed at the field office are in accordance with the remittance policy.
- Generated credit/debit card remittance guidelines based on the policy to increase processing time and effectiveness of the unit.
- Ability to receive in-coming mail and to process out-going mail to multiple components including packages that must processed through United Parcel Service (UPS).
- Team player and will assist wherever needed and will take additional responsibilities to attain the agencies goals.
- Work with manager and supervisor to develop a hiring plan that includes Veterans and their spouses, this is in an effort to capitalize on the experiences and talent to that demographic while ensuring the Olympia Servicing area has a pool of qualified individuals for hiring when the opportunity becomes available.
Transition Counselor
SERCO-NA
Ft. Lewis, WA
02.2014 - 07.2014
- Provided direct services to transitioning military personnel, Army civilians and their family members which included: conducting automated and manual pre-separation briefings, delivery of job assistance, training in group or individual settings, individual counseling sessions.
- Reviewed client’s pre-separations checklist to ensure compliance with transition requirements.
- Supported the Center’s marketing initiatives by briefing installation leaders and managers.
- Tracked the progress of clients and motivated clients to increase their utilization of the Transition Center and the center programs and resources.
- Managed supplies or assumed responsibility for a major activity such as job fairs, employer days or conduct classroom events.
- Familiar with standards of procedures, concepts, practices, and procedures used in the pre-separation process.
- Planned, organized, and communicated available programs and classes that may best suit the client’s individual transition plan.
- Assisted clients with the transition process including one-on-one counseling and by making referrals to other appropriate programs.
Veterans Case Manager/ Housing Resource Center Assistant
COMMUNITY ACTION OF SKAGIT
, WA
04.2013 - 02.2014
- Conducted client assessments or intakes to determine eligibility and to make referrals for services and interventions.
- Planned, coordinated, and executed the program to address the client’s needs.
- Corresponded with veterans using various forms of communication to inform them of the various programs that they qualify for based on the program guidelines and their need.
- Assisted veterans with establishing and developing an action plan which includes exploring resources, a budget, and housing to attain self-sufficiency and stability.
- Developed and maintained relationships with community partners to enhance the level of services provided to Veterans to be able to advocate for clients.
- Documented client information in the appropriate file.
- Monitored and tracked the program by evaluating client utilization and progress to make presentations to Board members and to answer important questions as it pertains to the program.
- Communicated and collaborated effectively with members of the organization, Board members, local service officers and personnel from other agencies.
- Assessed clients’ need for housing services by utilizing the Housing and Urban Development (HUD) guidelines and made referrals in the process.
- Communicated expectations, policies and guidelines to clients both orally and in writing.
- Counseled clients on the social, financial and personal aspects of their transition and relocation process to ensure sustainability and self-sufficiency.
Workstudy (Veterans Representative Assistant)
WORSOURCE
Mount Vernon, WA
09.2013 - 12.2013
- Greeted and directed clients to the appropriate individuals or classes.
- Assisted clients with faxing and copying in the resource center.
- Compiled various résumé writing and job search aides.
- Contacted clients to inform them of job opportunities and the application and referral processes.
- Liaised with clients and colleagues to determine their need and the best solution to the challenge that they may face.
- Utilized excel and word to derive various documents upon request.
Aviation Structural Mechanic
UNITED STATES NAVY
Oak Harbor, WA
02.2008 - 02.2012
- Examined components to diagnose, adjust and conduct maintenance action; reviewed and interpreted maintenance manuals and other publication to determine the method of repairing or replacing malfunctioning or damaged components.
- Utilized computerized tracking system to procure supplies, document hours worked and approve components that were ready for issue.
- Conducted cost/ benefit analyses to evaluate, propose and administer the most cost-effective strategies.
- Maintained records and receipts of files of equipment and supplies ordered.
- Managed and monitored programs to ensure compliance with established policies and procedures and communicated discrepancies orally with supervisor and generated the necessary documents required for corrective action.
- Applied judgment in necessary areas to reduce cost and improve efficiency in processes while complying with the standards of operation.
- Mentored 3 new employees, and provided the manager or supervisor with feedback on employee’s progress and various ways to proceed with training to get the best results.
U.S. Navy
02.2008 - 01.2009
- Financial Coaching Training – WA, 10/2013 Veterans Cultural Competence Training- WA, 09/2013 Veterans Benefits Training-WA, 07/2013 Operational Stress Control- WA, 08/11 Domestic Violence- WA, 08/11 Introduction to Suicide Prevention- WA, 04/11 Sexual Assault Prevention and Response (SAPR) Awareness Training-WA, 02/11 Sexual Assault Victim’s Intervention and Sexual Harassment, Grievance Training- WA, 04/10 Military requirements for Petty Officer Third Class - WA, 09/09 Lean Six Sigma White belt course -WA,, A/F 27T – 10 Operator/Maintainer Training Unit - VA, 08/08 U.S.
- Navy– Naval Aviation Technical Training Unit- FL, 07/08.
Instructor/Tutor
JUNIOR HIGH SCHOOL
Christiansted
10.2006 - 06.2007
- Utilized science curriculum to teach 80 students: established clear objectives, adapted teaching methods to meet students’ varying needs, utilized discussions and demonstrations and other instructional material to communicate lesson objectives.
- Aided students with homework assignments and research papers as part of an after-school program, provided one–on–one tutoring to students, evaluating, and recording progress throughout the program.
- Prepared tenth-grade students for English placement exam at a vocational school which resulted in all the students successfully completing the program and graduating on time.
- Maintained control of students in the classroom setting.
- Collaborated with other staff members to plan and schedule lessons using approved curricula.
- Provided guidance to students and advised them on study methods to improve their performance.
- Administered, graded and recorded tests and presented results to school principal for review.
Supervisor/Inventory Controller
CONSOLIDATED FOODS LIMITED
St. Lucia
10.2001 - 07.2003
- Assisted in the development, implementation, and evaluation of inventory procedures for the organization.
- Trained new employees including store managers and receiving procedures with hand-held scanners and use of company’s retail system.
- Reported performance and progress to the General Manager of Retail.
- Conducted store audits/inspections and company–wide audits/inspections of inventory and maintained records to assess integrity and to evaluate practices.
- Generated forms and reports necessary to effectively assess activities to be able to make recommendations.
- Employed a “Customers First” philosophy which helped improve customer satisfaction.
- Collaborated with staff to develop ways to improve the services offered at the store.
- Adhered to the safety and cleanliness standards at the store.
- Maintained a professional attitude and exhibited behaviors that went beyond standard requirements.
- Evaluated processes and reports and made recommendations to improve processes and reduce cost where applicable.
Education
11/2015 Certificate of Achievement in Essentials of Project Management -
Villanova University
2015
Master Certificate in Human Resource Management -
Villanova University
2015
SHRM Veterans at Work Certificate, SHRM through PsychAmrInstitute, 03/2020 Certificate of Achievement in Human Resource Management -
Villanova University
2015
MA - Organizational Leadership
Brandman University
2014
MS - Human Resource management
Brandman University
2013
BA - Psychology
Brandman University
2012
BS - Economics
University of the West Indies
2006
Certificate of Achievement in Mastering HR Organizational Effectiveness -
Villanova University
Skills
- MS Office, Word, Excel, PowerPoint, Outlook, OneNote
- Administrative, Navy
- Army, Organizing
- Benefits, Organizational
- Budget, Organizational skills
- Coaching, Personnel
- Concise, Philosophy
- Copying, Policies
- Counseling, Presentations
- Credit, Processes
- Clients, Progress
- Client, Project Management
- Customer satisfaction, Publication
- Data analysis, Receiving
- Debit, Recording
- Delivery, Repairing
- Drafting, Researching
- English, Research
- Faxing, Retail
- Financial, Safety
- Forms, Scanners
- General Manager, Six Sigma
- Government, Supervisor
- Hiring, Teaching
- Human Resource, Team player
- HR, Technical assistance
- Inventory, Technical Training
- Law, Tutoring
- Listening, Type
- Marketing, Website
- Mentor, Written
- Excel
- MS Office
- Office
- Outlook
- PowerPoint
- Word
- Works
- Naval
- System updates
- Customer support
- Database maintenance
- Clerical support
- Courteous demeanor
- Project management abilities
- Complaint Handling
- Customer Support
- Remote Assistance
Timeline
Claims Specialist
Social Security Administration
01.2023 - Current
Service Representative
Social Security Administration
07.2014 - 01.2023
Transition Counselor
SERCO-NA
02.2014 - 07.2014
Workstudy (Veterans Representative Assistant)
WORSOURCE
09.2013 - 12.2013
Veterans Case Manager/ Housing Resource Center Assistant
COMMUNITY ACTION OF SKAGIT
04.2013 - 02.2014
Aviation Structural Mechanic
UNITED STATES NAVY
02.2008 - 02.2012
U.S. Navy
02.2008 - 01.2009
Instructor/Tutor
JUNIOR HIGH SCHOOL
10.2006 - 06.2007
Supervisor/Inventory Controller
CONSOLIDATED FOODS LIMITED
10.2001 - 07.2003
11/2015 Certificate of Achievement in Essentials of Project Management -
Villanova University
Master Certificate in Human Resource Management -
Villanova University
SHRM Veterans at Work Certificate, SHRM through PsychAmrInstitute, 03/2020 Certificate of Achievement in Human Resource Management -
Villanova University
MA - Organizational Leadership
Brandman University
MS - Human Resource management
Brandman University
BA - Psychology
Brandman University
BS - Economics
University of the West Indies
Certificate of Achievement in Mastering HR Organizational Effectiveness -
Villanova University
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