Customer Service Project Manager

***** ****** ***** ** #****( HOUSTON TX ( *****

281-***-**** ( *******@*****.***

Shannina mack

Work of experience

**/****-******* *** *******, TX

Claims Examiner

. Review settled insurance claims to determine that payments and

settlements have been made in accordance with company practices and

procedures.

. Report overpayments, underpayments, and other irregularities. Confer

with legal counsel on claims requiring litigation.

. Enter claim payments, reserves and new claims on computer system,

inputting concise yet sufficient file documentation.

. Resolve complex, severe exposure claims, using high service oriented

file handling.

. Maintain claim files, such as records of settled claims and an

inventory of claims requiring detailed analysis.

. Researches, resolves and responds to claims requests related to the

initial set up of the claim.

. Contact with the field force, beneficiary and funeral homes to gather

or verify information.

. Provide customer service to Agents, Beneficiaries, Attorneys.

. Examine questionable claims investigated by Special Investigative

Unit, to determine whether to authorize payments.

. Ability to record, track and process claims manually.

. Accurately calculate reversals on premiums, dividends and paid up

addition refunds to properly pay out claims.

. Experience with excel spreadsheets and higher calculations

. Proficiency with computer skills such as Microsoft Outlook, Session A,

Client Builder and Excel.

. Ability to work independently in a fast paced environment.

02/2010-02/2012 Men's Wearhouse Houston, TX

Claims Processor/Customer Relations Representative

. Acting liaison between customers and employees for the Men's Wearhouse

Corporate office.

. Responsible for thoroughly investigating incident claims sent via e-

mail or by telephone.

. Reviewed each claim on case by case basis, and issue compensation for

claims.

. Research and audited tuxedo reservations to proactively correct issues

before they

. occur.

. Review and approve activity of direct reports including adjustments

entries, manual corrections, and processed refunds.

. Research, verify input and balance direct payments.

. Assisted customer with online trouble shooting and customer support.

. Advanced problem solving skills.

. Exceptional communication and customer service skills.

. Identifying and responds to problems with appropriate action and

follow-up.

. Working between multiple computer screens, using systems such as

Oracle, Pos, Microsoft Office and Excel.

02/2008-12/2010 Shy Girl Hair Design Houston, TX

. Salon Owner and Master Cosmetologist

10/2000-05/2005 Citi Bank Houston, TX

Collections and Customer Service Representative

. Providing customer service regarding collection issues, process

customer refunds, process and review account adjustments, resolve

client discrepancies and short payments.

. Responsible for monitoring and maintaining assigned accounts-customer

calls, account adjustment, and small balance write offs.

. Maintained Account Receivables for Shell, Bp, Texaco and Ammco Gas

cards account.

. Entered and processed payment information.

. Knowledge of billing and Collection Procedures and FDCPA Fair Debt

Collection Practices act.

. Adjusted complaints concerning billing or service rendered, referring

complaints of service failures to designated departments for

investigation.

education

. 04/2006-02/2008 Royal Beauty Careers Institute Houston, TX

Obtained a license to provide cosmetology services in the state of

Texas.

. 199*-**-**** Mayde Creek High School Houston, TX

High School Diploma

Texas All Lines Adjusters Licensed.

REFERENCES

Mark Powell -DMF Project Manager -American General -713-831-

2065

Shawndra Tone - Claims Coordinator -American General -713-831-

8935

Brandon Washington -CEP Trainer-713-***-****

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