Cdl class B, school bus driver

BERNADINA Naples

**** ****** ****, ********, ***** Tel: 773-***-****

SUMMARY OF SKILLS

- Leadership - Staff Development - Business Development

- Analytical - Strategic Planning - Process Improvement

- Communication - Customer Service - Account Management

- Presentation - Contract Negotiation - Marketing Initiative

PROFILE

• A highly capable professional with solid experience in leadership and

managerial roles, recognized with multiple promotions. Bilingual; fluent in both English and Spanish Specialize in operations, claim processing and staff training; proven success in building,

supervising and motivating efficient teams. Strong working knowledge

of medical claims. Detail oriented with an impeccable work ethic.

• A resourceful leader able to quickly identify areas of potential growth

and develop innovative strategies to maximize return on investments.

Manage projects from conception through completion; consistently deliver

timely results without ever sacrificing quality.

• A diplomatic, articulate communicator with exceptional presentation

skills; able to effectively interface with diverse individuals at all levels.

Successfully served in high volume call center environments, which included

hands on direct experience with customers and supervising agents.

RELATED PROFESSIONAL EXPERIENCE

AON 2014 to 2016

Lincolnshire, Illinois

Team Lead

Led team for customer solutions department. Sourced and solved all problem claims, benefits inquiries, 401k,

HSA, HRA inquiries and enrollment problems.

Independent Contractor for Lyft and Uber Ride Share Programs 2013 to present

AXA ASSISTANCE 2003 to 2010

Chicago, Illinois

Supervisor, International Claims

Oversaw all aspects of operations for International Claims; manage teams of

Claims Adjusters and Customer Service Agents. Provided extensive

training to Adjusters and Agents. Monitored daily production reports. coordinated multiple

systems . Responsible for reviewing, auditing and releasing all major claims.

Handled all back-end functions including adjustments, disputes, appeals, refund requests and

subrogation pursuit. Successfully cleared backlog of claims following system crash.

CELTIC LIFE INSURANCE COMPANY 2000 to 2003

Chicago, Illinois

Technical Review Unit Associate / Client Service Representative (2002 to 2003)

Investigated eligibility for pre-existing conditions, third party insurance,

rescission of coverage and/or motor vehicle accidents. Pre-determined

benefits.

GREAT WEST LIFE AND ANNUITY 1999 to 2000

Rosemont, Illinois

Member Service Representative

Fielded inquiries and provided exceptional service. Quoted benefits (e.g., PPO,

POS, HMO, Indemnity and Hospital plans) for medical, dental and vision.

Resolved claim issues within 24 to 48 hours. Collaborated closely with Providers

Relations team; verified contracts and forwarded pertinent credentials. Advised

members and providers of appeal options when appropriate; followed up on all

claim issues. Composed HIPAA and eligibility letters, as well as duplicate

explanation of benefits. Maintained current working knowledge of State mandates.

UNITED HEALTHCARE OF ILLINOIS, INC. 1997 to 1999

Chicago, Illinois

Personal Service Specialist

Managed membership base of 2,500; established and maintained lasting rapport

and provided outstanding service. Researched and advised members on all benefit

issues; addressed concerns and ensured timely resolution of all claims issues.

Maintained current working knowledge of all HCFA regulations and guidelines.

TRAINING

BIR TRAINING SCHOOL

Chicago, Illinois

• Received Certification in Medical Billing and Coding. 2005

EDUCATION

HARRY S. TRUMAN COLLEGE

Chicago, Illinois

• Associate’s Degree in Communications 1982

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