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Customer Service Life Insurance

Location:
Redford, MI
Posted:
January 15, 2020

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Resume:

SHALANDA GAINEY

adbbfb@r.postjobfree.com

313-***-****

Experienced with over 20 years of experience in Group Benefits and Customer Service Industry. Excellent reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements. Consistently improving company processing standards and customer satisfaction with continuous growth.

Expertise includes:

Group Benefits Facilitator Customer Service Leadership

Information Management Workflow Documentation

Detail Orientated Team Contributor

EXPERIENCE

Group Insurance Administrator

Metropolitan Life Insurance 10/1999 - 07/2019

Southfield, MI

2008 - 2019

Administered life insurance benefits for 300+ group customers exceeding set requirements and standards monthly. Consistently improved customer service scores and client retention.

Trained and mentored team on new customers, products, and procedures enabling a

Proficient outcome with improved audit scores for all.

Created, expanded, and improved job procedures to enable efficient workflows.

Subject matter expert for General Motors that enabled company to come under

budget

Processed claim transactions using 11+ recordkeeping and data management systems for accurate benefit payment.

2003 - 2008

Disability Claims Reviewer

Benefit determination, maintenance, and payment for short and long-term disability claims

within contract provisions and time lines.

Received and respond to various benefit inquiries from members, union benefit

representatives, plant medical departments, and employers.

Applied various pension and social security awards to reduce payable benefit liability by an average of 70%.

Contact with physicians, hospitals and medical facilities resulting in proper claim

management, payment, and duration.

Addressed and recovered disability overpayments.

2001 - 2003

Customer Service Agent

Provided superior customer service meeting and surpassing customer expectations by showing how important he or she was to the company by interacting with he or she in a friendly-helpful and positive way.

Responded to verbal and written inquiries concerning eligibility, beneficiary forms,

assignments, confirmations of coverage, billing inquires, death claims and plan definition per various contract provisions.

Provided plan documentation, forms, confirmations, denials, and claim forms per

requests and requirements.

1999 - 2001

IMO Scheduler

Contact with the company physicians to schedule medical appointments for employees on disability.

Contact with the employee to advice of medical appointment process and procedures.

Contact with the physician to obtain the medical examination results.

Coordinated with the employer and the employee a return to work date.

EDUCATION & TRAINING

Oakland County Community College, Southfield, MI

Mumford High School, Detroit, MI



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