Customer Service Human Resources

Stephanie Hidalgo

**** ***** ****** *****, ** ***72 - 347-***-**** Email:**********@*****.***

Qualifications

1. Hands on knowledge of insurance claims procedures, federal and state regulation and medical terminology.

2. Expert in processing all phases of New York State Disability and Short Term Disability quickly and accurately.

3. Excellent interpersonal and organizational skills.

4. Conscientious and self motivated; contributing team player.

5. Work well under pressure, handle multiple tasks and enjoy fast pace environment.

6. Proficient in use of Windows XP, Microsoft Word, Outlook.

7. Bilingual

Professional Experience

First Rehab Life Insurance Company, Great Neck, NY

DBL Claims Examiner, 2007 - 2012

1. Analyzed medical and vocational information to make initial and ongoing liability determination.

2. Increased productivity and made timely decisions about eligibility in compliance with federal and state requirements.

3. Reviewed settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures.

4. Calculated benefit payments and approved payment of claims within a certain monetary limit.

5. Reported overpayments, underpayments and other irregularities.

6. Data entry of ICD-9 codes

7. Developed strong relationships with Human Resource workers, Compensation Board and claimants to ensure high quality customer service.

MATRIX ABSENCE MANAGEMENT, INC., Hawthorne, N.Y.

Integrated Claims Examiner, 2006 – 2007

1. Made timely decisions about eligibility for Short Term Disability in compliance with federal and state requirements.

2. Analyzed medical, vocational and contractual information to make initial ongoing liability determination.

3. Monitored treatment plans to ensure that claimants adhere to goal of returning to work safely.

4. Developed and maintain strong relationships with customers and partner with medical providers, human resources to ensure delivery of high quality customer service.

Technical Assistant, 2003 – 2005

1. Managed claims paperwork and first reports

2. Expedited correspondences and update diaries

3. Corresponded with claimants, clients, and providers

4. Assisted in bill payment process

5. Data entry and documentation production

6. Use of claim system for letters and inquiries

7. Mail distribution, maintained department files.

Education:

Queens Adult Learning Center, Queens, NY

Certificate in Computerized Office Technology 1997

LAGUARDIA COMMUNITY COLLEGE, Queens, NY

Major: AA., Liberal Arts -50% Completed.

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