Customer Service Claims Specialist

Rafael Alvidrez

Claims Specialist

562-***-**** ***********@*****.***

Executive Summary

Dependable and service-oriented professional with expertise in processing and coding claims, ensuring all required criteria are met before eligible payments are issued to claimants. Proven track record of meeting targets, with strong analytical skills and attention to detail. Well-versed in working and collaborating in a fully remote professional environment.

Competencies

Research • Customer Service • Analysis • Complaint Resolution • Quality Control

Schedule Management • Process Improvement • Team Building • Employee Training

professional experience

Maximus, Remote

Fact Finder (September 2021 – Present)

Review employer protests of unemployment claims for potential eligibility issues

Make outbound calls as needed to interview employers for information verification to resolve any noted issues and discrepancies

Determine protest status, and process claims with confirmed eligibility issues for potential adjudication and determination by the California Employment Development Department

Document employer interactions, along with actions taken to supplement case notes

Collaborate with subject matter experts to address unique issues

Insurance Group, Bankers Insurance

Agent (February 2020 – August 2011)

Develop a client base by growing relationships with my network, establish and maintain strong customer relationships, offering guidance, and providing solutions to help families obtain financial freedom.

Obtain knowledge beyond licensed agent training through sponsored course work, and proprietary agent development training.

Presenting clients with the ability to preserve their retirement and grow their wealth. Use the latest software, and product illustrations to guide clients through important financial decisions.

Home Depot USA

ASM for different departments (June 2000-August 2011)

Manage Areas of Responsibility. Maintain department profitability through analysis, trend identification and responding to identified problems. Coordinate merchandising maintenance for multiple departments. Follow procedures for opening and closing sales areas.

. Ensure customers are satisfied. Recruit and place Sales Associates with appropriate skills. Ensure appropriate staffing in specialty areas. Set and monitor department sales goals. Training associates to provide quality customer service.

Recruit, interview and recommend qualified candidates to Store Manager. Make recommendations to Store Manager on starting pay and pay increases over time. Motivate, coach, train, and develop associates. Communicate Home Depot and store and store objectives to associates.

Accountable for direct supervision of the work activities of others. Planning, monitoring and reviewing work of subordinates is required. This may include direct supervision of a shift or the coordination of multiple work groups. Makes recommendations concerning selection, termination, performance appraisal and professional development.

education and professional affiliations

Bachelor of Arts in Business Administration, United States International University, San Diego, Calif.

Insurance license in Health and Life, and Property and Casualty.

technical proficiency

SharePoint, Smartsheets, Office 365, Microsoft Teams, NICE/IEX, InContact Virtual Contact Center, Fieldglass, multiple systems login utilizing different multi-factor authentication applications, 3270 HHSDC Session/DOS-based systems.

Contact this candidate