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Click here or scroll down to respond to this candidateCandidate's Name
Winter Park, FL Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEOver 20 years experience in Customer Service and Contact Centers Please note that the gaps in employment in 2018 and 2019/2020 were due to the preparation and completion of moving from Colorado to Florida and the COVID pandemic. Authorized to work in the US for any employerWork ExperienceLicensed Insurance Advisor- RemoteBrightway Insurance Agency - Jacksonville, FLApril 2023 to PresentResponsible for providing excellent quality service to existing and potential new clients while maintaining department standards for availability and call quality/accuracy Responsible for policy changes and maintenance of policies Responsible for providing proof of insurance on request to various home and vehicle lien holders Provided claims services and information, and walked clients through the claim submission process Remote Claims SpecialistThe Assistance Fund - Winter Springs, FLJuly 2022 to December 2022Provide support by reviewing, researching, investigating, processing, and adjusting medical reimbursement claimsResponsible for meeting department standards for claims processed per hour, and maintained benchmarksResponsible for determining if claims are duplicates and withdrawing, if necessary Responsible for liaising with insurance companies, patients, and service providers Complied with HIPAA patient privacy and security regulations Continued training and expanding my knowledge and understanding of medical claims processing Maintained Salesforce with current information and statuses of patients and Medical Reimbursement ProgramsRemote Insurance Operations ProcessorOscar Heath Insurance - Winter Springs, FLNovember 2021 to July 2022Responsible for drafting and composing letters to Medical Providers regarding resolution of disputed medical claimsResponsible for meeting department standards for claims processed per hour, and maintained benchmarksComplied with HIPAA patient privacy and security regulations Responsible for determining if claims are duplicates and withdrawing if necessary Assisted others on my team with questions and issues with processing claims Continued training and expanding my knowledge and understanding of medical claims processing Remote Customer Care AssociateFaneuil, Inc. - Winter Springs, FLOctober 2020 to July 2021Handled and responded to all inbound customer inquiries regarding Affordable Care Act Marketplace health plans for the State ofMassachusettsProvided excellent customer service while maintaining department requirements for call availability, adherence, call quality and customer surveysComplied with HIPAA patient privacy and security regulations Educated members and potential members on health insurance, Tax Credits and the enrollment process Assisted with Member Login and technical support issues for the Health Connector websiteAssisted prospects with the enrollment process online and via phone Assisted Training team by taking live calls for new training classes and assisted with training process Updated CRM system with detailed notes on each call Auto Claims AdjusterBristol West Insurance Group - Englewood, COOctober 2018 to June 2019Responsible for thoroughly researching each claim using all available tools, taking recorded statements from claimants and insureds, and documenting the claim file concisely Obtained photos of property damage and forwarded to inside appraiser for damage estimates Coordinated repairs with customers and body shops, also coordinated total loss situations including title procurement and salvage of total loss vehiclesProcessed payments to lienholders, claimants and body shops with 100% accuracy Responsible for providing excellent customer service to both external and internal clients Financial Services SpecialistNordstrom Card Services - Englewood, COJanuary 2018 to May 2018Responsible for handling inbound customer calls regarding Nordstrom Visa, Debit and store card questions of all kinds Maintained department quality expectations on calls and interdepartmental communications Met or exceeded department expectations for call availability Determined appropriate situations where credit increases, waiver of late fees and interest charges, and fraud/suspicious activity were neededApproved or declined new lines of credit with Nordstrom based on strict anti-fraud and financial appropriateness guidelines Responsible for providing excellent customer service to both external and internal clientsInsurance Sales/Retention SpecialistMountain High Insurance - Parker, COJune 2016 to April 2017Responsible for policy changes and maintenance of policies Sold property and casualty insurance policies via phone, email, or walk in appointments Responsible for providing proof of insurance on request to various home and vehicle lien holders Provided claims services and information, and walked clients through the claim submission process Customer Service SpecialistCharles Schwab & Co, Inc - Englewood, COAugust 2015 to March 2016Institutional Investor- Call Center, Responsible for handling participant calls, answering in-depth account inquiriesMaintained department quality expectations on calls and interdepartmental communications Met or exceeded department expectations for call availability Responsible for creating Research and Resolution Requests on the participant's behalf, and following the requests through to final completionParticipated in focus groups aimed at improving the participant experience Office Manager/ Insurance Sales/ Retention Specialist State Farm Agent State Farm Insurance - Denver, COJanuary 2014 to August 2015Responsible for policy changes and maintenance of policies Sold property and casualty insurance policies via phone, email, or walk in appointments Prepared nightly deposit report, and responsible for deposit of customer premium cash/check payments Responsible for providing proof of insurance on request to various home and vehicle lien holders Provided claims services and information, and walked clients through the claim submission process Office Manager/Fulfillment SpecialistFleuriste Craft Supply - Centennial, COAugust 2012 to January 2014Responsible for handling all aspects of customer service, from emails, phone calls and walk-ins, and increasing sales through cross selling, up selling, and product awareness Responsible for business presence in social media, from managing the Facebook page to completing weekly blog and e-newsletter Responsible for the day to day operations of the office while owner is out, including managing labor and schedules of employeesMaintain quality expectations for customer service satisfaction rates- domestic and international customersTrain and mentor new hiresResponsible for maintaining inventory on two websites Client Support SpecialistADP - Aurora, COJanuary 2011 to August 2012Responsible for handling client calls regarding payroll, tax, and systems questions Maintained department quality expectations on calls and interdepartmental communications Met or exceeded department expectations for call availability Trained and mentored new hiresResponsible for providing excellent customer service to both external and internal clients EducationArapahoe Community College - Littleton, COSkills Customer Service Expert; Claims Processing ;Property & Casualty/Health Insurance; 20+ years Contact Center Experience (10+ years) Financial Services CRM Software Insurance Sales HIPAA Salesforce Office Management Communication skills SalesCertifications and LicensesProperty & Casualty LicenseLife & Health Insurance License |
