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Click here or scroll down to respond to this candidateCandidate's Name
Miami, FL - PHONE NUMBER AVAILABLE - EMAIL AVAILABLEPROFILEHighly organized i with over 10 years of measurable achievements building and leading operations through steady growth. Consistently recognized for delivering continued quality service, improved productivity and increased profitability. Visionary leader with ability to build cohesive teams, maximize revenue growth and exceed corporate goals and objectives.HIGHLIGHT OF QUALIFICATIONSReceived highest possible rating in all categories on new-employee 60-day evaluationRecognized for determination in setting and achieving goals and exceeding targetsExceptional communicator with strong negotiation, problem resolution and client need assessment aptitudeExcellent relationship building, and presentation skillsHighly motivated, goal oriented and skillful negotiatorPROFESSIONAL EXPERIENCEDentaQuest - Doral, FL 2017 CurrentClaims SpecialistEducate customers and dental professionals on eligibility, benefits, claims payment, and authorizations.Provides direction on the usage and benefits of self-service tools.Assist members on gaining access to care by locating a network dentist or assignment to a primary care dentist.Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.Work closely with providers, members, and clients to properly resolve claim issues.Work with management to increase auto adjudication rates and self-service utilization.Process map workflow and lead resolution of ad hoc scenarios.Performed all work in accordance with customer and company standards.DentaQuest - Doral, FL 2013 2017Customer Service RepResponded to and resolve internal and external general customer inquiries via verbal and written communications through all channels including phone, email, web portal, and chat interactions.Educate customers and dental professionals on eligibility, benefits, claims payment, and authorizations.Assist members on gaining access to care by locating a network dentist or assignment to a primary care dentist.Document all customer interaction.Understand and adhere to all of DentaQuests administrative and contractual policies and procedures.Understand and adhere to all of DentaQuests administrative and contractual policies and procedures.Interpret and communicate accurate insurance coverage by having a comprehensive understanding of the process.American Senior Advisors Miami, FL 2010 - 2013Loan OriginatorGenerated sales calls, contacted existing and potential clients to develop new businessMet with prospective clients, explained the different types of loans and credit options available, as well as the terms of those services; analyzed applicants financial status, credit, and property evaluationsDeveloped and implemented marketing strategies to establish new client baseActed as liaison between lender and clients including application processing, pre-qualification and evaluation of purchase contracts.Florida Transportation Credit Union Miami, FL 2007 - 2010Member Service RepresentativeExceeded monthly referral goal (quota) by 60% for banks products and servicesAssisted existing and potential members by explaining specific products, services and policies including membership eligibility requirements and identifying specific needs as well as cross selling products and servicesProvided information regarding new and ongoing marketing promotionsBalanced the ATM, the vault, and the office at the end of each dayPower Financial Credit Union Miami, FL 2004 - 2006Member Service RepresentativeAwarded and maintained excellent scores for anonymous Customer Service programGathered needed information from members to opened new accounts explaining options such as single joint ownership, savings shared drafts, certificates and retirement programsOpened new accounts / Processed loan applicationsUnion Planters Bank Miami, FL 1999 - 2003Commercial Loan AssistantContributed to the increase of the branchs overall customer service ratings by 35%Prepared and processed commercial accounts; Assisted in closing of loansExamined and reviewed loan documentation for accuracy, timeliness and completenessAnalyzed and verified applications to determine clients creditworthinessEDUCATIONMiami Dade College Business Associate Degree |
