Customer Service Insurance

Yvonne M. Gocha

* *********** ***. ***. *.

Marion, IA 52302

abipu9@r.postjobfree.com

678-***-**** Cell

Professional Experience:

Toyota Financial Services, Cedar Rapids, IA

Customer Loyalty Advocate & Collections Representative - November 2009 -

Present

Accountable for maximizing repeat vehicle sales through various contact

points with customers.

Participating in marketing campaigns targeting customers approaching lease

maturity and customers in positive equity retail contracts. The intention

of these contacts is to influence repurchase decisions.

Fielding inbound calls from customers approaching lease maturity and/or

responding to messages left during our outbound campaigns, providing

answers to any questions they may have and persuading customer to remain in

the Toyota family.

Accountable for accurate and timely handling of all aspects of customer

account maintenance and transactions.

Retrieving payment history from available systems and clearly communicating

the status to the customer.

Analyzing account characteristics and working with customers to resolve

their issues.

Negotiating with customers to bring their account current and/or

recommending appropriate solutions while providing best in class customer

service.

Knowledge of retail / lease accounts and account specific options

Reviewing customers history, where appropriate, based on established

policies, procedures

Documenting all activities in a clear and concise manner utilizing the

appropriate systems and in accordance with established procedures.

Demonstrating strong organizational skills and attention to details.

Computer skills: Microsoft Word, Excel, Outlook and Lotus Notes.

ZC Sterling Insurance Agency, Atlanta, GA

Property and Casualty Claims Representative - November 2008 - November

2009

Negotiated with contractors and claimants regarding scope of damage, repair

costs and settlements.

Analyzed claims to determine course of action and coverages involved in a

timely fashion.

Evaluated risk associated with claims involving bodily injury (liability

claims).

Create purchase requisitions and place orders for 3rd party vendor

services.

Conducted telephone interviews, took recorded statements from

insured's,claimants, witnesses.

Interviewed injured persons to determine extent and severity of potential

loss.

Assigned claims to independent field adjuster to inspect property, obtain

photos, write estimate of damages.

Reviewed/interpreted policy coverages and determined if payable under

policy, deductible, actual cash value or replacement cost.

Documented all activity related to loss and evaluated the loss/damages.

Determined subrogation/salvage potential, prepared files for arbitration

when necessary.

Built a network of trusted vendors.

Microsoft Suite, Microsoft Word, Outlook and Excel

Progressive Insurance, Tucker, GA

Auto Claims Adjuster - May 2007-July 2008

Processed auto claims from date of loss until resolution by identifying

coverage and determining liability.

Evaluated bids, selected and recommended suppliers and negotiated prices.

Conducted telephone interviews and obtained recorded statements from

insureds, claimants, witnesses.

Documented file with all activity related to loss, prepared and handled

correspondence related to claim.

Prepared files for arbitration when necessary

Explained/Interpreted coverages and limits.

Estimated damages to all vehicles involved in claim and negotiated repairs

with body shops.

Settled bodily injury claims.

Issued drafts when required.

Provided status of claims and explained claims process to all parties

involved in claim.

Extensive customer contact, Microsoft Word, Outlook and Ultramate software

Attended company sponsored educational programs to maintain knowledge of

products, producers and industry trends.

Rich Printing Inc., Suwanee, GA July 2005-May 2007

Customer Service/Account Representative

Managed customer accounts by: generating aged invoice reports, issuing

statements, invoices and past due notices.

Resolving delinquent accounts, answering customer account inquiries.

Perform data entry of sales orders via email, fax or phone. Provide

technical

support by answering product and shipment inquiries.

Write up custom printing job orders Assist pre-press with proof reading and

proof changes.

Duties also include filing, collating, answering phones and maintaining job

record log.

Extensive customer contact, use Microsoft Word, Excel and Mass 90 software.

Dental Health Associates, Alpharetta, GA Feb. 2004-Feb. 2005

Patient Accounts Representative

Managed patient accounts for multiple offices and processed insurance

explanation of benefits forms and denials.

Resolved outstanding claims and refiled claims when required.

Verified patient refund requests and investigated discrepancies in patient

accounts. Made account adjustments.

Provided patient account/insurance support to staff at all offices.

Pediatric Associates at Johns Creek, Suwanee, GA Feb. 2001-Sept. 2003

Patient Accounts Representative

Created insurance and patient delinquent account reports (over 30 days) and

followed-up on all denials.

Filed and tracked electronic and paper claims, including Medicaid claims

and

payments.

Analyzed claims to determine why denied or paid incorrectly.

Extensive telephone contact with provider relations and member service

representatives. Documented all contact.

Provided support to front office staff for scheduling, checking in/out

patients,processing insurance changes using Base Med Software.

Chamberlin Edmonds & Associates, Inc., Atlanta, GA Feb. 2000-Sep. 2000

Client Support Specialist

Assisted clients (indigent and uninsured) in obtaining and providing

necessary

information in order to process state and federal

Medicaid/Medicare application

requirements.

Accompanied or represented clients at appointments with state and federal

agencies.

Screened potential clients through an inbound calling system, if accepted,

set

up initial interview with out-stationed representative.

Prudential/Aetna Insurance, Albany, NY Oct. 1997-Dec. 1999

Claims Examiner

Responsible for processing 50+ electronic claims per hour, including

sensitive

and performance group claims.

Reviewed suspended electronic claims for quality and tracked trends in

examiner errors, providing feedback and training to examines failing

to meet

quality and quota standards.

Assisted customer service department during open enrollment.

Community Health Plan, Latham, NY Jan. 1993-Oct. 1996

Member Services Representative

Addressed and documented inquiries from members, vendors and physicians in

regards to benefit coverage, proper procedure for in/out of plan

referrals,

emergency care, and authorization for out of area medical treatment,

claims,

and filing of complaints.

Resolved and provided follow-up.

Additional responsibilities included providing benefit information to

prospective members during open enrollment, directing calls to proper

departments, updating member information such as: name, address or

primary

care physician, generating letters for proof of coverage or

termination,

answering requests for provider directories and insurance cards, and

resolving

any written requests.

Extensive use of Microsoft Word, Microsoft Office.

Education:

Washington State University, B.S., Microbiology/Medical Technology

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