Customer Service Insurance

Anita Alltop, FCLS

Availability to Interview & Start

ASAP

PROVEN PERFORMER – successfully completed a long-term

contract role for us at Chubb Insurance and received high marks

from the manager. Additional extensive and exceptional

background at Travelers Insurance.

Expert in high volume call center, fraud, insurance claims

investigation, workers compensation, problem research and

resolution, data entry via dual monitors/applications, worked with

Please explain why you feel this

medical staff, trained new hires, medical records, and much more!

candidate is best fit for this

Proficient in MS Office Suite and quick learner of new software.

position/provide any additional

Positive, loyal, detail oriented, and highly organized.

comments

Wants to work at AIM and hopes for an offer!

PROFESSIONAL EXPERIENCE:

Staffing Company at UPS 01/2017 – 09/2017

Fraud Associate (Contract)

Customer service oriented, Internet based fraud dealing with identity theft in sending/receiving packages, cancelling accounts when fraudulent and working with customers to adjust their invoices.

Staffing Company at Chubb Insurance

11/2013 – 11/2016

Workers Compensation Analyst/Fraud Analyst (Contract)

Recipient of multiple positive reviews acknowledging dedication to excellent customer service. Ensured superior customer experience by addressing customer concerns by demonstrating

empathy and resolving problems.

Set reserves on files, prepared file for review, paid client invoices. Handled all incoming business and client request for information Met challenging quotas for productivity and accuracy of work.

Managed a wide variety of customer service and administrative tasks to resolve customer issues quickly efficiently.

Prepared mailings of information and documentation.

Staffing Companies (Various Contract Positions)

01/2009 – 11/2013

Worked with the General Liability and Workers Compensation claim adjusters to conduct various database searches using Lexis/Nexis person reports, ISO reports and also internet/social media searches.

Responsible for overseeing private investigators work product and monitoring the file throughout the investigative lifecycle.

Take the lead role in developing an Investigative Action Plan (IAP).

Monitor the progress of the private investigators to ensure the on-time delivery of the final investigative product.

Reviewed the Private Investigator’s final report and summarize the results of the investigation. Contacted law enforcement agencies for police reports, diagrams of accidents and any other case

documentation.

Collected premiums on all direct collection files.

Drafted investigative reports covering all phases of each case.

Ran 25 – 30 special projects and initiatives at the local and regional level.

Reconciled data and direct collections with the accounting system to address discrepancies.

Travelers Insurance

11/1985 – 11/2008

Entered numerical data into databases in a timely and accurate manner. Obtained scanned records and upload into the database.

Reviewed medical records for accuracy and files the records in the proper order. Defused volatile customer situations in a calm and courteous manner.

Accurately documented, researched and resolved customer service issues.

Improved call center functionality and service capacity by resolving customer complaint efficiently and quickly.

Trained new employees on multiple medical billing programs and data entry software. Conducted research to address customer concerns.

Carefully documented statements, observations and evidence materials.

Safeguarded physical evidence and maintained the proper chain of evidence. Guided and trained several SIU investigative analysts.

Trained new staff members of external in internal fraud.

Compared the investigators final report with the video surveillance.

Reviewed and analyzed suspicious and potentially fraudulent insurance claims. Prepared prosecution packages and restitution proposals.

EDUCATION:

FCLS Certification: Insurance Law, American Educational Institute (2005)

Insurance Billing, Law, Risk Assessment, Claims, and Collections. National Insurance Crime Bureau (2001)

Medical Assistant, Medical Institute of Minnesota

Transcription, Insurance Billing, Organizational Behavior, Compensation, Labor Relations and Recruitment.

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