Customer Service Quality Assurance

GRACE Margate, FL *****, RODRIGUEZ 954-***-**** *****************@*****.***

PROFESSIONAL SUMMARY

Highly skilled Employee Benefits Accounts Specialist ensuring optimal service in the group and individual benefits.

Reliable candidate ready to take on challenges using problem-solving and task prioritization skills to help team succeed. Stays on top of demands in fast-paced environments by effectively using slow periods. Maintains organized, clean, and safe work areas with diligent attention to important details.

Dedicated professional with demonstrated strengths in customer service, time management and trend tracking. Good at troubleshooting problems and building successful solutions. Excellent verbal and written communicator with strong background cultivating positive relationships and exceeding goals.

SKILLS

• Experience in quoting Auto, Life, Health, Critical Illness, Voluntary,

Hospital Indemnity, health Savings

Account, Flexible Spending Account,

Dependent Flexible Spending Account, Core benefits and 401K plans.

• Excellent organizational skills; ability to set and give direction. Ability to organize prioritize, monitor, and

accomplish tasks.

• Knowledge of Microsoft Word and

Excel. I have worked for Aetna, Coventry, Cigna, Humana and United Health Care.

• Analytical Thinking

• Friendly, Positive Attitude

• Critical Thinking

• Troubleshooting

• Analytical and Critical Thinking

• Microsoft Office

• Decision-Making

• Written Communication

• Quality Assurance

• MS Office

• Benefits Explanation

• Employee Relations

• Documentation and Reporting

• ADP Workforce Now

• Benefits Administration

• Training Support

• Compliance Reporting

• Personnel Records Management

• Attention to Detail

• Regulatory Compliance

• Records Maintenance

• Job Description Development

• Interpersonal Communication

• Remote Office Availability

• Organization and Time Management

• Flexible and Adaptable

• Internal Controls

• Root Cause Analysis

• Audit Coordination

• Report Writing

• SOP Adherence

• Continuing Education

• Forecasting

• Issue Resolution

• Audit Plan Development

• Report Generation

• Audit Reporting

• Bookkeeping

• Account Reconciliation

• Report Creation

• Financial Management

• Accounting Principles

• Contract Compliance

• Audit Management

• Bank Reconciliation

• Financial Controls •

Advanced Mathematics

• Fraud Identification

• Financial Data Analysis •

Accounting Oversight

• Risk Management

• International Accounting Standards •

Financial Reporting

• Accounts Payable

• Critical Thinking and Analysis •

Accounting Records Analysis

• Statement Review

• Financial Litigation Support •

Financial Statements Review

• Journal Entry Preparation

• Accounting Processes •

PeopleSoft

• Financial Projections

• Audit Planning •

Compliance Software

• Documentation and Reports

• Financial and Regulatory Consulting •

Data Collection

• Staff Training

•Typing and 10-Key Entry •

•Employee Training

Reporting and Documentation

• General Ledger

EXPERIENCE

Senior Benefit Counselor

Mercer Marsh & McLennan Norwood August 2019 – September 2023

•Assisted employees with their group benefit plans by educating and assisting them with the enrollment process, resolving their issues with the benefits

•Provided explanations regarding coverage policies, limits and deductibles in consideration to the customer's needs.

•Claims retiree counselor

•Assist with claims, coverage matters, and was rated number one in processing claims.

Humana Louisville, KY April 2014 - August 2019

•Answered an average of 200 calls per day by addressing customer inquiries, solving problems and providing new HUMANA product information

•I explained the benefits and features of Humana health care plans

•Provided explanations regarding coverage policies, limits and deductibles in consideration to the customer's needs.

Auditor June 1986 - September 1992

Banca Serfin New York, New York

•Prepared detailed reports on audit findings.

•Carried out efficient audits based on preliminary reviews and outlined plans.

•Helped improve internal controls by evaluating systems and recommending updates.

•Compiled comprehensive records for planned audits.

EDUCATION

Associate in Arts (A.A.) - Accounting

Cumberland County College, Vineland, NJ 08360

December 1978

LANGUAGE

English Spanish Fluent Native

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