Customer Service Insurance

PATRICIA DORSEY

*** ******* *******, **********, ** 30022 · 678-***-****

***.********@*****.***

PROFESSIONAL SUMMARY

Dynamic Professional with over ten years of experience working within insurance and financial services

Strong technical knowledge of employee benefits, claims, health programs, financial products, pension benefits and customer service; Excellent communication skills and proven relationship building; attention to detail, proactive and self-motivated; able to meet deadlines and goals for concurrent projects working both independently and with a team

Proficient in MS Office Suite, data-entry and typing, various software packages, and system navigation (researching policies, applicable regulations, customer account info, etc.) EXPERIENCE

JUNE 2017 – PRESENT

BENEFITS ADMINISTRATOR II, METLIFE ALPHARETTA, GA

Effectively perform complex tasks around core processing and administrative functions of the Benefits Claims Services department. Ensure correct procedures are followed and perform detailed review of death claim process and procedures for the central Abandoned Property Unit.

Perform high- value financial transactions in a consistently accurate and timely fashion.

Review correspondence, annuity benefit calculation reports, contracts and referrals for accuracy and ensure due diligence; update databases and spreadsheets.

Proactively assisted management in compiling a Standard Operating Procedure guide to cross train current and new employees that saved time and increased production. DECEMBER 2016 – APRIL 2017

ESCALATIONS RESOLUTION ANALYST, AON ALPHARETTA, GA

Ensured resolution and resolved complex account issues and ensured customer satisfaction. Assisted customers and clients with benefit processing, research for proof of enrollments, auditing, customer statements, processing refunds and cancellations

Managed accounts to ensure contractual service levels/ guidelines were met

Proactively created and developed training guidelines that increased productivity. NOVEMBER 2015 – JANUARY 2016

MEMBER SERVICE REP/ ADVOCATE III, ALTEGRA HEALTH ALPHARETTA, GA

Interacted with health plan members from multiple insurance carriers through outbound and inbound telephonic contact to review and assess Medicare health plan member’s eligibility. Ensured eligibility for state and local government and community programs.

Enrolled members in programs based on state and federal regulatory requirements

Proven ability to successfully market, sell, and promote company services effectively. 2

OCTOBER 2011 – AUGUST 2015

RETAIL CENTER SERVICE ADVOCATE, BLUE CROSS BLUE SHIELD ESTERO, FL

Spearheaded group benefits information sessions, open enrollment meetings, marketing, and health fairs; strategically developed and maintained relationships with new business contacts that increased center traffic by 25%; negotiated contract allowances and write- offs with healthcare providers that saved members over $20,000 in payments.

Provided a customer focused experience for inquiries regarding health insurance

(benefits, claims, premium payments, eligibility, and plan enrollment) Medicare, Healthcare Reform and wellness; member advocate for complex claims disputes, appeals, billing issues and coordinated benefits resolution. MARCH 2008 – OCTOBER 2009

BENEFITS SERVICES SPECIALIST, NORTHWESTERN BENEFIT CORP ATLANTA, GA

Developed and maintained positive client relationships with management team for small employer groups for insurance broker

Assisted HR managers, executives, employees and vendors with inquiries received via phone, email and face to face regarding complex benefits and claims issues

Administered multiple insurance plans, contracts and interpreted laws, policies/ procedures. Monitored COBRA notification process and collaborated with vendors; reviewed, processed and submitted paper and electronic plan enrollments/ terminations. AUGUST 2003 – MARCH 2008

CUSTOMER SERVICE REPV II/ RETIREMENT SPECIALIST, TEACHERS RETIREMENT SYSTEM OF GEORGIA

Effectively counseled and educated over 300,000 members regarding eligibility, plan options, retirement benefit estimates, cost calculations, disability requirements and law interpretation;

Promoted from Call Center in 2005 to fulfill a broad range of functions in Service Purchase department for active employees; efficiently administered defined benefit pension plan; processing checks, in-service withdrawals, lump sum refunds, posting payments, stop payments; managed service records and reports; handled inquiries and resolved complaints.

EDUCATION

BACHELOR OF SCIENCE DEGREE, SOCIAL WORK,

FLORIDA STATE UNIVERSITY TALAHASSEE, FL

LICENSE – (LAS) GEORGIA LIFE, ACCIDENT AND SICKNESS- ACTIVE SKILLS

Medical, Dental, Vision, Life, Health, Retirement

Proficiency in: Windows, Word, Outlook, Excel

Customer focused, Collaboration,

Negotiation, Escalation Resolution

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