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Skills

Warehousing functions
Training development aptitude
Credit card processing
Medical terminology knowledge
Professional telephone demeanor
CRM
Industry-specific legal collaboration
Claims data analysis and reporting
Retail store support
Key holder experience

Work Experiences

Provided primary customer support to internal and external customers in a fast-paced environment.
Used a POS system to itemize and total the purchases of 14 customers.
Provided ongoing guest service, which included Microsoft Excel recommendations.
Increased customer retention by creating and offering unique discount opportunities, as well as generating interest in new product lines.
Assisted and cross-trained other customer service managers.
Established long-term, loyal customer relationships by providing excellent service and detailed order, account, and service information.
Followed through on all critical inter-departmental escalations to increase customer retention rates.
Acquired 13 new customers, resulting in 9% revenue for the team.
Recommended, selected, and assisted in locating and obtaining out-of-stock product based on customer requests.
Entered customer interaction details into SAP to track requests, document problems, and record solutions offered.

Summaries

Customer service specialist with over 11 years of experience resolving account and service issues for Miscellaneous clients.
Senior Claims Consultant proactive with experience in providing support and resolving customer complaints.
Hardworking Senior Claims Consultant with 2 years of telecommuting experience meeting customer needs.
Customer Service Representative with exceptional oral and written communication, active listening, and problem-solving abilities.
Effective at managing phone calls, emails, letters, and in-person requests for assistance while adhering to procedure regulations and process department guidelines.
Dedicated to exceeding expectations and leading the team to success.
Senior Claims Consultant is a service-oriented Senior Claims Consultant with unrivaled customer service, task prioritization, and time management skills.
Tableau expert with experience in client relations services.
Under duress, personable and professional.
Successfully identified and resolved challenges while promoting company products and maintaining loyal, satisfied customers.

Accomplishments

Used Microsoft Excel to develop inventory tracking spreadsheets.
Trained team of 10 claims specialists on handling catastrophe-related claims, reducing errors during peak periods by 85%.
Partnered with external law firms to manage complex claims litigation, achieving a 64% lower-than-industry-standard legal cost per claim.
Managed claims team of 6, resulting in a 44% improvement in customer satisfaction scores within 15 months of implementing new procedures.
Led escalated claims resolution team, reducing outstanding claims by 15% over three years.
Designed and conducted a 12-week training program improving claims processing accuracy by 38%, maintaining a customer satisfaction rating of 62%.
Standardized interdepartmental communications between compliance, underwriting, and claims teams, reducing backlog by 53%.
Identified trends in rejected insurance claims and collaborated with the technical team to develop automated error detection, reducing rework rates by 71%.
Created targeted training modules on regulatory compliance for claims processing, leading to a 77% decrease in post-settlement legal challenges.
Developed and implemented steps to mitigate fraudulent claims through Microsoft Excel, reducing cost of fraudulent claims reimbursements by 16 annually.

Affiliations

American Marketing Association
Association for Supply Chain Management (APICS)
American Medical Informatics Association
National Association of Independent Insurance Adjusters (NAIIA)
Lions Club
Society of Women Engineers
Society of Claims Professionals
Association for Computing Machinery
Insurance Institute of America (IIA)
Association of Certified Fraud Examiners (ACFE)

Certifications

Certified Insurance Claims Specialist (CICS) – Ironclad Systems
Associate in Claims (AIC) - Ironclad Systems
Certified Specialist in Insurance Operations (CSIO) – Cedar Works
Certified Insurance Counselor (CIC) - Beacon Labs
Project Management Professional (PMP)
Apple Certified Associate (ACA)
Certified Professional in Fraud Analysis (CPFA) – Brightline
Microsoft Certified Systems Engineer (MCSE)
Certified Professional in Insurance Adjusting (CPIA) – Harbor & Co.
First Aid/CPR Certified

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