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Skills

  • System implementation
  • Customer relationship management
  • Call center experience
  • Process documentation
  • Freight operations
  • Quality control
  • Inventory control
  • Conflict resolution
  • Customer Service regulations knowledge
  • Claims Process Optimization

Work Experiences

  • Prepared and sold a diverse range of customized merchandise to both individuals and businesses.
  • Consistently outperformed my daily credit card application goals.
  • Completed a variety of tasks to meet the needs of customers, such as processing and issuing money orders, managing returns and exchanges, and logging daily shipments on a daily basis.
  • Devised and implemented process improvements in order to reduce workloads and improve callback efficiency.
  • Provided excellent customer service by following up on issues, automated and coordinated.
  • Increased retail sales by 3% and increased customer traffic by 7%.
  • Provided Jira consultations to customers, addressing category concerns.
  • Conducted customer interviews for system issues and provided feedback to the management team.
  • Provided senior management with detailed monthly departmental reports and updates.
  • Ranked as the most effective in improved out of 7 representatives.

Summaries

  • Capable of recognizing and resolving issues while promoting new products and meeting sales targets.
  • Working with regulatory limits and process department standards to handle requests via email, letter, phone calls, or in person is second nature to me.
  • Capable Claims Customer Care Representative who understands how to manage procedure routes while providing excellent customer service.
  • Expert in both individual and team roles, as well as training and mentoring new employees on company goals.
  • Detail-oriented, quick to respond, and adaptable to changing circumstances.
  • Mentoring and coaching skills in a dynamic professional.
  • Managing paperwork, collecting payments, and resolving issues are all skills I have.
  • Claims Customer Care Representative is an energetic and dependable Claims Customer Care Representative who has been well-trained and excels in high-end merchandise environments.
  • Bilingual Customer Service Representative with a track record of resolving complaints and issues quickly and effectively.
  • Professional with a strong understanding of how to solve customer problems efficiently and civilly.

Accomplishments

  • Collaborated on a cross-functional team to implement a new claims management system, reducing processing times by one year.
  • Reduced claim intake time by revamping call scripts and workflows, leading to an improvement of 80% in first-contact resolution.
  • Devised and implemented a customer-first protocol strategy that improved overall claims satisfaction by 42% across a diverse client base.
  • Resolved customer claims involving system, resulting in process and improving resolution rates by 72%.
  • Streamlined the entire appeals process, resulting in a 38% improvement in resolution time for denied claims.
  • Leveraged CRM and ERP systems to resolve over 10 customer disputes with a success rate of 25% in 2015.
  • Resolved over 17 escalated customer claims per month by accurately identifying issues through digital CRM tools.
  • Resolved 71% of claims during the first point of contact, reducing the necessity for secondary claim filings.
  • Achieved a 35% increase in client satisfaction by implementing real-time customer feedback mechanisms during claims processing.
  • Took ownership of complex claim records, consistently applying policy knowledge to recover a total of $11 in misprocessed claims.

Affiliations

  • Completed Professional Customer Interaction Certification (P-CIC) through the National Customer Service Association (NCSA) in 2016.
  • Completed Lean in Post-Call Analytics from the Customer Experience Professionals Association (CXPA) in 2024
  • Member of the Customer Engagement Association, engaged in shared initiatives for improving end-to-end claim process strategies.
  • Joined the International Customer Management Institute (ICMI) for advancing skills in call center management and support strategies.
  • Member of the International Customer Service Standards Council (ICSSC), dedicated to optimizing quality standards in claim interactions.
  • Certified in Call Center Operations through the Customer Service Institute of America (CSIA), 2016
  • Affiliated with the Customer Contact Association (CCA) for learning new enhanced call triage and escalation resolution techniques.
  • Contributing member to the Claims and Litigation Management Alliance (CLM) for research and innovations on dispute resolutions.
  • Achieved membership in the Professional Association for Customer Engagement (PACE) focusing on quality in claims customer support.
  • Participant in the Insurance Customer Care Excellence Forum, leveraging monthly educational sessions for client retention techniques.

Certifications

  • Certified Adjuster License Arizona
  • Certified Business Analysis Professional (CBAP)
  • Customer Service Excellence Certification Cedar Works
  • Certified Insurance Service Representative (CISR)
  • Google Certified Professional Cloud Architect
  • CompTIA Network+
  • Certified Professional Coder (CPC)
  • Insurance Data Processing Certification HubSpot
  • Project Management Professional (PMP)
  • Apple Certified Associate (ACA)

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