Claims Examiner, Customer Service Representative
Resume:
Kathy Miller
Rochester, New York *4625
*********@*****.***
QUALIFICATIONS and ATTRIBUTES
● Long term experience with professional attitude, attention to detail, dedicated
● Initiative, seeks continuous improvement both personally and in business processes
● Strong written and verbal communication skills
● Works productively both independently and within a team
● Decisive
● Self-motivated; goals focused
● Problem analysis and resolution oriented to exceed customer expectations
● Community and service oriented
EXPERIENCE
MetLife, Oriskany, NY 1992-2017
Senior Disability/FMLA Customer Specialist
● Claim data entry, review and decision making with continued management, caseload of 100 to 150 claims based on demand
● Incoming and outgoing calls with resolution to claim issues and providing information to employers, employees, medical providers, attorneys, account managers and insurance brokers based on specific company plan provisions
● Prepared written correspondence relaying information to both employees and employers and also in response to questions and requests from law offices
● Overpayment recovery
● Close written and verbal communication with human resource contacts, managers, employees of plans and medical providers on a daily basis
● Main employer contact for several companies (i.e. Consolidated Edison, Elkay Manufacturing, and Solvay Pharmaceuticals)
● Performed all system testing for new business prior to implementation and co-partnered with management and other appropriate partners to resolve issues for seamless launch
● Assisted with training and mentoring regarding
● Telecommuted, strength in time management, prioritizing workflow, e-mails and voicemails responses
EDUCATION
High School Regents Diploma, Hilton, NY
TECHNICAL SKILLS
● Microsoft Office Suite
● Medical terminology
● Federal and State Disability statutes, Family Medical Leave Act parameters and HIPPA
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