Quality Assurance Life Insurance

Krushaliben Shah

San Antonio, TX ***** *****.****@*****.*** 818-***-****

QUALITY ASSURANCE ANALYST

Data driven Quality Assurance Analyst with career expertise in medical underwriting. Adept in helping clients resolve financial issues. Collaborative professional skilled in processing claims via online/portal for different types of claims including property, auto and liability claims.

CORE COMPETENCIES

Medical Underwriting Life Insurance Open Enrollment Compliance

Claims Management Client Services Program Planning Accounting Quality Assurance

TECHNICAL SKILLS

C++, ASP.net, Sql, MS Access, Windows 98 & 2000 & MS Office, Tally – Accounting Software, SAP

Amazon call center Connect, Avaya Communicator, IBM Notes, Compass, Omni View, Customer One

Genesys, Temenos, ECM for Payments, FDCPA ACT

PROFESSIONAL EXPERIENCE

SWBC BANK San Antonio, TX February 2023 – Till date

Payment reminder Services Representative

Through inbound/Out-bound callings, collects past due payments and /or payment arrangements to resolve delinquent accounts.

Uses sound judgement and follows client and corporate policies to determine suitable collection solutions.

Consistently documents conversations clearly and concisely in required collection system, accurately updated borrower personal information to provide financial institution.

Accurately processes electronic payments using the ECM/Portal System.

Accurately investigates questions, problems or complaints and promptly refer complex situations to the appropriate resources to ensure client and borrower satisfaction

Have through knowledge of Genesys and Temenos software.

Accenture (Prudential Life Insurance of America) San Antonio, TX February 2022 – October 2022

Senior Customer Service Representative / QA Analyst

Responds to incoming calls from clients and/or employers

Explained detailed process about medical under writing.

Explained the difference between Basic life, optional life/ Supplemental life, Whole life, Term life and Individual life Insurance.

Discussed the policy term and coverage options based on plan provided by their employer.

Developed and maintained professional business relationships through verbal and written communication with team members, employers, and HR Assistance members

Ability to work with multiple personnel under minimal supervision

Actively meet aggressive metrics and performance standards on a daily basis

Communicated details about what is covered under Short and Long Term Disabilities.

Assisted with Conversion and Portability process when they become former employee.

Helped with enrollment in life insurance during open enrollment.

Filled out health questionnaire form.

Helped or Scheduled medical checkup appointment in order to get Life insurance.

Set up an EFT for customers.

Resolved issues for clients regarding billing discrepancies.

Explained escalation process to understand denial letter.

Sent the copy of policy, update Beneficiary, change in coverage.

Processed the request for changing in policy coverage.

Sent emails to supervisor regarding Billing Issues, Denial letter, escalation for cancelled coverage, refund issue and follow up with Supervisor and update the same to customer as well via Outbound call.

Bank of America – San Antonio, TX November 2021 – December 2021

Customer Service Representative

Helped client to solve their financial problems.

Handled inbound/outbound calls.

Entered all information related to client/call in CSS and excel.

Utilized CRM systems and practices & MS office.

Monitored contact center calls to: score for client experience, compliance, and procedural adherence using customized scorecard Managed large amounts of incoming/outgoing calls.

Identified and assessed clients’ needs to achieve satisfaction.

Supported procedure documentation, training, and creating reports.

Provided accurate, valid, and complete information by using the right methods/tools.

Met personal/client service team targets and call handling quotas.

Handled client complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.

Kept records of client interactions, process client accounts and file documents.

Collabera Inc. (Client – Accenture) – San Antonio, TX May 2021 – September 2021

Project: Ohio department of job and family services

Assisted with automation of finance department’s manual processes by writing VBA code and using macros and formulas to speed processes and maximize accuracy.

Managed large number of claims every day.

Worked for pandemic unemployment assistance claims.

Used Excel functions in development, focusing on read/write integration to databases.

Prepared visible columns and formulas; imported data from SAP and exported data for metrics

Worked on monetary claims.

Met personal team targets by handling more than 100 claims per day.

Verified all documents for EX. SSN, Income verification, address proof, date and year for claim filing etc.

Verified all income related proof for the past year.

Checked out thoroughly all Identification proof.

Verified all documents before submitting claims.

Submitted claims for Pandemic unemployment assistance.

Kept records of client interactions, process client accounts and file documents.

Tracked all claims number worked for the day.

Customer Service Representative / QA Analyst, February 2021- April 2021

(Was on Maternity since October 2019 – January 2021)

Project: Vaccine Management System

Entered all information related to client/call in CSS and excel.

Handled inbound/outbound calls.

Monitored contact center calls to: score for client experience, compliance, and procedural adherence using customized scorecard Managed large amounts of incoming/outgoing calls.

Provided accurate, valid and complete information by using the right methods/tools.

Met personal/client service team targets and call handling quotas.

Handled client complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.

Keep records of client interactions, process client accounts and file documents.

Followed communication procedures, guidelines and policies.

Answered phone calls to book an appointment for vaccination, cancellation of appointment and rebooking of an appointment.

Trained subordinate for the same role.

Tracked booked appointment.

Minto Insurance Agency (Farmers Insurance Group) – San Antonio, TX, Full time January 2019 – October 2019

Customer Service Support/Administrative Assistant) Part time – January 2018 – December 2018

Entered client service notes into excel files after any contact for future reference.

Answered client phone calls answering questions and offering services.

Kept rack of upcoming policy payment due using excel.

Created charts and Graphs in excel, used pivot table when needed.

Met with potential client to explain all insurance options.

Collected and updated client information to ensure coverage was correct.

Assisted clients in filing claims as well as making and receiving payments.

Maintained regular consistent and professional attendance, punctuality, personal appearance, and adherence.

Issued/ordered binders, evidence of insurance, and certificates of insurance as requested.

Focused on sales to create new business and retain existing accounts to facilitate retention and company growth.

Worked with different underwriters to bind policies to get a better rate

Worked with Finance department to receive payments or installments towards policy premium

Prepared ACCORD 125, 126, 140, 130 and 127 for general liability, property, loss of property, notice of cancellation and worker’s comp.

Prepared quotes for worker’s comp, life insurance, property (Home and commercial) insurance and car insurance

Processed claims via online/portal for different types of claims including property, auto and liability claims.

Prepared quotes for vacation homes, rental house and RV.

Larsen & Toubro Limited, Baroda, Gujarat, INDIA May 2013-March 2016

Program Coordinator at Switch Gear Training Center

Program Planning: Prepared Training Calendar in line with availability of resources. Distributing training schedules to HR department of various organizations. Proactive reminders and follow-ups for nominations with HR representatives. Final conformation, Registration of members and Fees Collection. Create VBA programs to automatically update Excel workbooks, encompassing class and program modules and external data queries.

Administrative Activities: Managed collection and record keeping of Nomination forms in excel, Maintain Printing of training material, Distribution of Training Kits, Memento and Certificates, Vehicle arrangement and transportation planning.

MIS: Generated Monthly Reports for all training center’s activities excel using multiple formulas, collection, man-days, visitors, feedback and review.

Accounting: Assisted with payment advice made in excel, Performa invoice made in excel, O/S collection used excel formulas, Vendor payments, Service entry, Purchase requisite.

Jalaram Sales Corporation, Baroda, Gujarat, India January 2010-January 2013

Administrative Assistant

Maintained the Stock, as well As Accounting & Tally Services.

Involved in Preparing Quotations, Bills, and Purchase Orders.

Coordinated with client and head office.

P.R. Mehta Car Rentals, Baroda, Gujarat, India July 2008-December 2009

Administrative Assistant at

Involved in Car Hiring Business. Booking of orders and Vehicle Management.

Assisted with Branch Office Management, Accounting, Time bound Services.

EDUCATION

Master of Computer Application

Bachelor of Commerce from M S University, Baroda

ACADEMIC PROJECTS

Creation of Restaurant Reservation Management system covers all the details of Restaurant business, from booking, payment, etc.

E-Soft Online Software Auction System (Code Tracking System)

LANGUAGES

English, Hindi, Gujarati

Contact this candidate