Veronica-Ann Garza

Manage client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then deliver final determination based on trained skillsets and/or partnerships with clinical and other Humana parties. Perform advanced administrative/operational/customer support duties that require independent initiative and judgment. Use intermediate mathematical skills. Remote position.

Provides first line customer service contact for claims reporting activity related to personal lines. Creates loss reports by obtaining information from policyholders, claimant, and other parties. Establishes and maintains information screens and inputs data into necessary software as required. Establishes the claim master record by direct entry of claim data into appropriate systems. Verifies coverage under various policies or policy provisions based on variances of state, jurisdiction and regulatory requirement. Makes direct assignments to inside or field claims specialists for prompt resolution of claims. Refers claimants to preferred repair shops or schedules drive-in appointments as appropriate. Thoroughly and efficiently handles inquiries from policyholders, claimants and others. Responds effectively and appropriately to sensitive events and/or situations as needed. Establishes and maintains a follow-up system for completion of claim reports.

Member contact position. Within defined guidelines and framework, provide Property & Casualty (P&C) member experience by performing customer service, sales, and retention activities for one or more USAA personal lines products that occur across multiple contact channels (i.e. inbound calls, email, chat, social media, etc.) to provide adequate coverage and advice to ensure member's financial security aligns to USAA standards.

Preformed general office duties such as ordering supplies, maintaining records management systems. Client relations and customer service. Also receiving and delivery of product and daily product inventory.