Customer service representative with many years experience
working in a fast-paced, high volume environment. Detail oriented with solid background in
prioritizing, problem solving and organizational skills. I work well as a team member or independently. Prior experience includes handling disability and workers' compensation claims.
Creative problem solver
MS Windows proficient
Credit card processing Type 45-50 words per minute Fluent in Spanish
Front Customer Coordinator10/2009 to Current TJ Maxx – Groton,
Greet customers entering the store to ascertain what each customer wanted or needed.
Politely assisted customers in person and via telephone.
Provided an elevated customer experience to generate a loyal clientèle.
Ensured superior customer experience by addressing customer concerns, demonstrating empathy and resolving problems on the spot.
Built long-term customer relationships and advised customers on purchases and promotions.
Routinely answered customer questions regarding merchandise and pricing.
Replenished supplies, bags and other materials at each cash wrap.
Folded and arranged garments in attractive displays.
Customer Service Representative2006 to 2007 Panorama Flight Service – White Plains,
Responsible for all front desk operations in a busy privately owned Air Charter Company.
Greeting incoming customers departing or arriving from flights Responsible for answering the phones in a timely manner Schedule reservations for customers at local hotels, car rentals, car service and catering services Answer inquiries regarding flights and departures Maribel Rodriguez.
Claims Coordinator2005 to 2007 OneBeacon Insurance Company – White Plains,
Responsible for scheduling eight staff appraisers for inspection of vehicles damaged in accidents.
Proposed strategy that reduced usage of independent appraiser by 15%
Effectively scheduled appointments for eight appraisers within a 2 hour time frame
Increased productivity by 7% in the state of Massachusetts
Assist in achieving Drive-in goals by promoting on all appraisal request
Document all files in CWS (company database) with all relevant information regarding appraisal and dispatch operations.
Workers' Compensation Claims Specialist1991 to 2004 AIGCS, Inc – Tarrytown,
Responsible for prompt and accurate claims handling of first report
Confirmed coverage, oversee direction of medical treatments and timely disbursement of indemnity benefits
Properly reserved files within 14 days of receipt of claim and maintain the reserve for life of claim
Assigned internal and external investigators for covert activities and surveillance to help determine claims validity
Medical Bill Analyst1991 to 2004 AIGCS, Inc. – Tarrytown,
Responsible for prompt and accurate processing of medical bills according to the Workers' Compensation Fee Schedule
Collect bills, sort and batch them by specific categories
Data entry of all medical bills in the internal company database
Resolution of suspended bills within 48 hours
Proficient with medical ICD-9 codes and procedural codes
Handled internal and external calls.
Medical Claims Specialist1991 to 2004 AIGCS, Inc. – Tarrytown,
Verified policies, coverage and set up claims.
Responsible for medical management, processing bills and closure of claims within 60 days.
Transfer of files to claims specialist once claim was indexed by the Workers' Compensation Board, injured worker started losing time from work and/or treatment became excessive.
Claims Assistant1991 to 2004 AIGCS, Inc. – Tarrytown,
Responsible for all clerical functions for a team of 8 claims specialist.
Responsible for processing state mandated forms, typing of manual checks for benefits, copying, ordering supplies and filing mail.
Handled internal and external calls.
Assisted with switchboard when warranted.
Integrated Claims Examiner01/2008 to 07/2009 Matrix Absence Management, Inc. – Hawthorne,
Claim decision within 3 days of receipt of the medical certification
Direct medical reports to Nurse Case Management
for review when warranted
Answer all inquiries regarding a claim
Handle day to day diary system to manage the
Send correspondence to the claimant's regarding
acceptance or denial of the claim
Schedule weekly, bi-weekly or bi-monthly
disability payments to the claimant's
Confirm a return to work and closure of all the claims
Associate Degree: Business Administration - Customer RelationsBerkeley Business College
- White Plains,
NY Business Administration - Customer Relations
benefits, bi, clerical, copying, Data entry, database, direction, filing, forms, frame, ICD-9, managing, Microsoft Excel, mail, Microsoft Outlook, Microsoft Word, policies, scheduling, Fluent in Spanish, strategy, switchboard, phones, Type, typing