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Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLE PHONE NUMBER AVAILABLE Tampa, FLSUMMARYSeasoned professional with 19 years of diverse experience, including two years as a Claims Examiner at Health-Net/Center Corporation, adept in reviewing and authorizing insurance claims and ensuring accuracy. Proven track record in customer service roles, including Claim Service Representative at Geico, excelling in customer engagement and claims processing. Seeking a Claims Examiner role to leverage expertise in claims handling, customer satisfaction, and detailed-oriented claim reviews. WORK EXPERIENCEMoffittService Response Operator Apr 2023 - Present Efficiently process incoming requests through various communication channels, ensuring prompt service delivery and customer satisfaction. Monitor critical systems, including fire alarms, building automation, and security video, to maintain facility safety and operational integrity. Coordinate rapid response for facility and equipment issues, dispatching appropriate maintenance or security personnel as required.GeicoClaim Service Representative Jun 2022 - Apr 2023 Served as the initial point of contact for policyholders post-accident, delivering empathetic customer service and accurately gathering facts essential for claims processing. Analyzed policy contracts to facilitate the efficient settlement of undisputed non-injury claims, ensuring adherence to policy terms and conditions. Enhanced customer satisfaction by maintaining clear and professional communication, thereby establishing trust and demonstrating subject matter expertise.ProgressiveClaims Loss Reporting Representative Oct 2020 - Apr 2022 Efficiently processed initial loss reports by accurately entering data into the claims management system and completing all necessary documentation. Coordinated the assignment of vehicle damage appraisals and procured police reports to facilitate the claims evaluation process. Conducted outbound calls to involved parties to gather essential information, ensuring thorough documentation and timely claim folder creation.MaximusCustomer Service Representative Sep 2019 - Jul 2020 Managed inbound inquiries on Medicare-related topics, ensuring accurate information on eligibility, enrollment, coverage, and benefits was communicated. Provided comprehensive customer support, resolving queries and facilitating a clear understanding of healthcare options and entitlements.Health-Net/Center Corporation Tampa, FLClaims Examiner Mar 2017 - Jan 2019 Analyzed and processed insurance claims, ensuring accuracy and compliance with policy guidelines; adeptly coordinated with relevant parties to resolve discrepancies and secure necessary documentation. Facilitated healthcare access for veterans by managing appointment logistics, confirming authorizations, and coordinating with medical providers to schedule timely services. Communicated effectively with veterans, providing them with appointment details and follow-up information, while also overseeing the submission of provider payment information post-appointment. General Dynamics Riverview, FLInternal Support Group Jun 2013 - Jan 2017 Provided technical support to customer service representatives, ensuring efficient resolution of customer inquiries. Managed escalated supervisor calls, facilitating effective communication and problem-solving to maintain customer satisfaction.Customer Service Representative Aug 2012 - Jun 2013 Addressed inquiries related to Medicare eligibility, enrollment procedures, coverage options, and benefit details, ensuring accurate and timely information dissemination. Provided customer support by resolving issues and guiding customers through complex healthcare processes, enhancing their understanding and satisfaction.Divi Carina Bay Beach Resort & Casino Christiansted, St. Croix, U.S. Virgin IslandsGaming Supervisor / Dealer Aug 2004 - Apr 2012 Ensured adherence to gaming regulations by vigilantly monitoring customer and employee activities, as well as overseeing secure money transfer and cash handling processes. Managed daily operations within specific casino sections, guaranteeing comprehensive coverage and smooth functioning of all stations and games. Facilitated a variety of gambling games, including blackjack and roulette, while meticulously complying with established rules and procedures.McDonalds Albany, NYSupervisor Jun 2001 - Feb 2002 Managed team operations, ensuring adherence to quality standards and excellent customer service by evaluating performance, delegating tasks, and overseeing disciplinary measures. Conducted financial tasks including cash management and payroll processing, while also training staff in food preparation, sanitation, and safety protocols to maintain compliance with health regulations. EDUCATIONDelaware Valley Job Corps CenterHigh School DiplomaCallicoon, NYSep 1992SKILLSBilling and Cashier Communications Conflict Resolution Databases Microsoft Office Multitasking Problem-Solving Sales Delegation Team Leadership |
