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Customer Service Medical

Location:
Illinois
Posted:
October 12, 2015

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Resume:

CAROLINA MARTINEZ

**** ***** *** ** **********, AR 72834 martinez acr2bh@r.postjobfree.com

Mobile:479-***-****

PROFESSIONAL SUMMARY

* Strong analytical skills with an attention to detail and willingness to learn and grow.

* Exceptional writing and communication skills in both English and Spanish.

* Self motivated and willing to perform tasks above and beyond what is expected.

* Displays leadership and supervisory of subordinates through engaging in work related tasks given. Demonstration by example of what is expected.

* Conflict resolution through establishing a personal rapport and gaining confidence in the parties that are in dispute.

PROFESSIONAL EXPERIENCE_ ABC Children’s Academy Dardanelle, Arkansas 2013 to 2015 Human Resources/Benefits Coordinator

* Fulfilled a broad range of HR functions, including recruiting, new hire orientation, administering benefits, overseeing disciplinary action and managing HR records.

* Process all salary changes stemming from merit increases, promotions, bonuses, and pay adjustments.

* Resolved conflicts between employees and insurance carriers, coordinated health fairs to promote employee wellness and performed exit interviews.

* Improved employee morale by leading employee survey that led to creation of performance management and incentive program. Also, re established company newsletter and improved training programs.

* Assisted with daily scheduled classroom operations, to include lunch preparation and coordinating classroom coverage.

* Provided aid, individually and in small group settings as dictated by specialized lesson plans.

* Demonstrated and reinforced positive social standards of behavior and discipline.

* Established and practiced acceptable norms of classroom behavior for young children. ASAP Personnel Services – Little Rock, Arkansas 2012 to 2013 Bilingual Administrative/Staffing Assistant

A company dedicated to assisting clients with the placement of quality individuals for both temporary and permanent employment positions.

* Established rapport and coordinated interviews of potential prospects with client companies.

* Performed administrative and clerical duties of which included receiving inbound calls on multiple phone lines.

* Ability to communicate effectively with prospects who wrote and spoke Spanish.

* Executed company policies and protocols, involving schedule checks, recruitment, reference and credential verification, testing applicants and the interview and screening process.

* Demonstrated multitasking abilities in a fast pace environment, while maintaining professionalism and successful time management skills

* Executed leadership in a team environment with focus on business growth through placement of personnel.

Transamerica Employee Benefits – Little Rock, Arkansas 2010 to 2012 Bilingual Claims Customer Service Specialist

Served as a frontline contact in the call center, to provide accurate and courteous service to members, policyholders, providers and employee representatives through various forms of communication media phone, email, and written documentation. Services included customer inquiries and complaint resolution.

* Provided benefit coverage for supplemental health policies (cancer, accident, critical illness and hospital confinement)

* Followed up on client claim statuses with an emphasis on documentation review for accuracy.

* Review client contract information with employer contacts, agents and customers to include life insurance, short term and long term disability policies, and supplemental health policies.

* Assisted various employer contacts with navigating company website, password inquires, adding new employees and employee enrollment, follow up on claim status, requesting billing statements.

* Assisted Spanish speaking customers in all areas of service.

* Additional job functions included processing group rate/employee sheets and benefit rosters.

* Acted as a liaison between the customer and medical provider by providing medical coverage information while following compliance with the HIPAA Privacy Rule.

* Analyzed documents and claim forms for accuracy, reviewed benefits coverage, and followed up with customers on claims process.

Friendship Community Care – Russellville, Arkansas 2005 to 2010 Direct Support Professional

A non profit organization providing care for over 900 children and adults with intellectual and developmental disabilities throughout the state of Arkansas since 1972.

* Assisted/supervised/mentored individuals with preparation of daytime activities while encouraging good personal hygiene and behavior appropriate within a home environment.

* Taught community integration assisted individuals in joining community organizations of their choice.

* Instructed self medication intake skills as well as problem solving skills/resolving conflicts.

* Responsible for performing daily log recordings and data collection.

* Advised oncoming shift and support staff of critical information pertaining to clients. ConAgra Foods – Russellville, Arkansas 2003 to 2005 Production Scale Operator Supervisor

* Successfully aligned computerized scaling equipment to ensure proper weight achieving 100 percent of overall quality production goal.

* Managed and maintained the operation and production of over 50 employees.

* Supervised employees in the areas of production and inventory.

* Continuously inspected produce to maintain the highest level of quality.

* Facilitated corporate and government mandated training meetings bilingually. EDUCATION M.B.A., University of Phoenix, Little Rock, AR

Business Administration

B.A., Arkansas Tech University, Russellville, AR

Spanish with History and Political Science minor

PROFESSIONAL SKILLS

* Fluent in Spanish reading, writing, verbally

* Proficient in Microsoft Word, Excel, PowerPoint, Outlook

* 10 Key Stroke

CERTIFICATIONS

* Claims and Customer Service Certification (Transamerica Employee Benefits)

* LOMA 280 Principles of Insurance Certificate.

COMMUNITY SERVICE

*S aint Augustine Church Managed Food Drives, Sunday Classes for children ages 7 10, additionally, taught English as a second language during Adult Evening Classes.

* Volunteer Spanish Translator for medical and court appearances.



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