Customer Service Claims Representative

Sherin Virani

214-***-****; ************@*****.***; https://www.linkedin.com/in/sherin-virani-52813580/

Highly motivated and team oriented professional with excellent communication and customer service skills seeking a position in a busy office setting. Twenty -five years of experience in customer service and Twelve years of experience in Insurance field, with a strong belief in leading by example. I am a goal driven individual, who is loyal and dependable. I believe in the business I work for, and I have a passion to make them shine.

EDUCATION

R.A Poddar College of Commerce & Economics 1995 Bachelor of Commerce

BUSINESS EXPERIENCE

Ameri life / Senior Healthcare Direct August 2021 – Present

Quality Assurance Analyst

Analyzes and evaluates Agent’s interactions while giving constructive feedback.

Ensure quality services is delivered as well as accurate information is given to client.

Verify and analyze over 20 insurance application and policy weekly by maintaining accuracy and compliance with CMS and FEMA requirements

Assist in building Medicare Advantage compliance-based training for Call center environment that focus on reducing CTM risk

Create and update Quality Monitoring Form for each interaction along with Corrective Actions Form if needed with constructive feedback as per policies and procedures guidelines.

Timeous compilation of Quality Performance report daily/weekly /monthly and send it to relevant department

Transamerica/ Tata Consultancy Services Plano, TX September 2008 –August 2021

Licensed Insurance Agent and Claims Representative

Provides an in-depth report regarding status and achievements to supervisor about tasks being worked on.

Assists new hire with new skills and helps develops an understanding about procedure through QA training.

Analyzes and evaluates policies and initiates claims by sending necessary documents to policy holders

Processes billing payment information as to customers’ needs and policy provisions

Reviews claim forms received and delivers it to be finalized after evaluation

Achieved high sales and retention percentage with value-focused customer service approach

Always maintains a pleasant and cordial attitude, even when faced with obstacles

Engages customers and provided a high level of service by carefully explaining details about their products

Performs in-depth research and investigation to handle more complex situations including discrepancies in suspense items to seek efficient resolutions.

Implementations are prepared after developing test plans, procedure, and applying any modifications.

Offers mentoring through explanations and scenarios to help and support new hires through Quality Assurance training.

Comet Cleaners August 1999 – September 2008

Manager Rowlett, TX

Successfully managed a team of 12 team members in multiple locations

Analyzed past marketing strategies and assisted implementing new ideas to attract more customers

Created and stayed within budgeting constraints to maximize efficiency and reduce unnecessary costs

Hired, trained, and managed employees to provide quality standard service

Resolved and addressed customer questions, issues and complaints immediately and in a correct manner.

Developed and implemented preventive and corrective actions

Monitored daily activities and provided detailed reports and updates to the owner

AWARDS AND CERTIFICATIONS

Certification in Life and Health Insurance, Texas Department of Insurance 2008

Certification in Life and Health Claim 2016 Awarded several Platinum Awards for Top Customer Service and Sales Representative 2008- Present

SKILLS

General and Health Insurance

Quality Assurance

Claims -Knowledge of Claims file management processes in insurance field

Able to conduct customer needs assessment and values customer relationships

Excellent communication skills

Critical thinker and result- oriented team player

Active listening skills and open-minded learner

Organized and efficient productivity

Possess strong interpersonal skills resulting in relationship building with prospects.

Multitask efficiently and accurately under pressure and deadlines

Effectively train and lead others on new processes and procedures

Possess strong attention to detail

ADDITIONAL INFORMATION

Tools: Equipped in being able to operate and use Microsoft Word, Microsoft Excel, Google Suite

Languages: Conversationally can communicate in Hindi, Gujrati, Urdu, and fluent in English

Eligibility: Eligible to work in the U.S. with no restrictions

REFERENCES

Available upon request

Contact this candidate