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Customer Service Complex Claims

Location:
Spokane, WA
Posted:
September 10, 2023

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Resume:

Pa M. Vue

**** *. ******* ****

Spokane, WA *****

509-***-**** (Work)

509-***-**** (Cell)

Email: adzltx@r.postjobfree.com

EDUCATION:

June 1995 Eastern Washington University Cheney, Washington

Bachelor of Arts in Liberal Arts

June 1995 Spokane Community College Spokane, Washington

Associate of Arts

WORK EXPERIENCE:

Dec 1999 – Present Took basic and complex claims and performed the following functions.

Basic Claims: Washington; Reopens/Additional.

Questions Monetary re-determination for wage correction (RX1)-add/delete/find (wages as earned); Override re-qualifications; Purged of previous disqualifications; Claim cancellations; backdated of Initial Claims; RO's (no subsequent employment); AC's (have had subsequent employment); Issued detection and setting of issues; Resolved newly discovered separation issues which can be purged; continued claims (weekly certifications); CC input Utilize interpreter service; Call message recording (CMR); PIN resets; Address changes; IRS-set indicator to have/not have deductions taken; Checked for special wages; ID verification; Set union indicator where appropriated; Reissued checks; Alternate Base Year (ABY) claims; Mailing of forms (generate form/computer; Tracers on missing checks; affidavit of loss/forged endorsements – determined whether they can re-issued the check or needed to get documentation; Finding the correct employment acct #; Presentation of Benefits Rights.

Complex claims: Unemployment Comp-Federal Employment; Unemp Comp-(e) X military; Temporary Total Disability; Facilitate interstate; filed claim as agent for another state used template IB14; Referred those who must file in another state to that state – each state's process was different; Combined Wage Claims (CWC) & reverse); (Some of the above complex claims could be combined, meaning options for the claimant must be explained). Determined order of liability ( of options prior to ABY); IVRS – troubleshooting when system informed them to contacted a live person (cc9); Over payment detection/referral; Explained over payment offsets; Explained regular denials; Explained appeal/re-determination process; Explained fraud; Explained when child support had attached benefits received; Explained how to claim through IVRS; Answered inquiries: options available; interpretation of law; crisis situations (last resort=UI claim); Troubleshooting; Referral to community resources; job search requirements; Standby letters; Explained all reductions and deductions from benefits (e.g., pension or severance pay issues; over payment offsets; earnings and needed documentation from claimant regarding pensions); Explained earnings and pension deductions; Explained base year; waiting period; Clams and apologizes to customers when appropriated; Maintains a working environment that supports quality customer service, effective communication and team building; Understood and provided leadership in the accomplishment of the agency's mission, performance standards, and objectives; Participated in assessing Tele-Center service delivery performance, as necessary, and applied continuous quality improvement principles to ensure customer satisfaction; and Conducted and controlled telephone interviews with customers. In addition to my job (Unemployment Claim Specialist III), I was also a part-time adjudicator. As a part-time adjudicator, I wrote a non-separation such as: Union issues, Backdate claim issues, Untimely claim issues, Missing Employer Information issues, Incomplete Employer Information, and Re-determination claim issues. I used UTAB system to do my work daily.

May 1996 – Jul 1998 SeaFirst Bank, Spokane, Washington

New Account Auditor

Duties: Audited and solicited new accounts. Approved solicitation, secured card, and maintained account on Cardpac. And updated monthly reports.

Dec 1989 – May 1996 SeaFirst Bank, Spokane, Washington

Office Assistant IV

Duties: Processed new applications and maintained existing accounts, updated credit bureau disputes, processed forms for additional information, opened mail, answered the phone, and used the copier machine. Contacted customers for additional information such as proof of employment. Mailed credit rating information.

Jul 1987 – Dec 1989 SeaFirst Bank, Spokane, Washington

Proof Operator

Duties: Processed single items, answered phone, made count on tellers' daily work, and encoded checks through proof machine.

Mar 1986 – Dec 1989 Credit Bureau Services, Spokane, Washington

Typist

Duties: Typed and filed.

CERTICATES/HONORS:

1985 Teller Training Institution

-Teller certificate and bond certificate

SKILLS:

Languages: Hmong (fluent) read, write, and speak.

REFERENCES: Upon request



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