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Click here or scroll down to respond to this candidateCandidate's Name
Dallas, TX Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEExperienced Customer Service Administration Professional experienced optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence. Astute professional highly skilled in customer service and relationship building. Talented individual offering dynamic skills in data entry, telephone support and records oversight. Customer Experience ManagementProblem ResolutionCall Center OperationsProgram PromotionCustomer Inquiry Management (CIM)Insurance CollaborationRisk ManagementComplex Problem-SolvingHealth Insurance Industry KnowledgeDatabase ManagementReport WritingLiability DeterminationsClaims File Management ProcessesMicrosoft WordClaims ProVirtual Customer Service Agent, 03/20/2023Current Teleperformance Dallas, TXResolved customer complaints by determining cause of problem, selecting best solution and expediting correction or adjustment.Responded to website and email inquiries within 2 business days to maintain customer satisfaction and generate positive reviews.Collected data and developed detailed spreadsheets to identify trends and create revenue, profitability, and expense forecasts.PROFESSIONAL SUMMARYSKILLSWORK HISTORYPerformed complex financial and budget analyses to determine requirements and justify requested funding. Bolstered customer retention by creating and offering unique discount options and inspiring interest in new product lines.Reduced process inconsistencies by over 85% and effectively trained team members on best practices and protocols.Liaised with sales, marketing, and management teams to develop solutions and accomplish shared objectives.Lead Claims Adjuster, 02/2019 - 03/2021Progressive Dallas, TXReviewed police reports, medical treatment records, and physical property damage to determine extent of liability.Established relationships with clients and insurance companies to foster timely claims resolution. Authenticated and executed controls to assure that the quality of the work meets or exceeds standards. Reviewed and analyzed processes, procedures, and workflows to identify opportunities for process improvement and efficiency.Performed timely coverage analysis based on policy information and facts or allegations of each case. Worked with other examiners in oversight or team handling situation or assignments. Managed the resolution of assigned claims by negotiating disposition of claims with insureds and claimants or their legal representatives.Benefits Verification Specialist, 11/2016 - 02/2019 United Healthcare Dallas, TXChecked employees' benefits enrollment for accuracy and inputted all data into Oracle NetSuite ERP. Reviewed patient deductibles and/or copays and flag the information into the billing system, so information is provided to the front-end departments and administrators. Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions. Explained benefits to plan participants in easy to understand terms in order to educate each on available options.Exhibited flexibility in handling unusual situations, initiative, and performs additional duties as assigned with a positive attitude.Incorporated industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.Maintained professional demeanor by staying calm when addressing unhappy or angry customers. Collected and reviewed all patient insurance information needed to complete the benefit verification process.Worked independently on assigned tasks, as well as to accept direction on given assignments, and handle conflict in a reasonable manner.High School Diploma: 05/2016Hot Springs High SchoolEDUCATION |
