Benefit Coordinator Intake Specialist
Resume:
Sugar Vinas
Injury Benefit Coordinator
**********@*****.***
San Antonio, Texas 78245
Experience
Injury Benefit Coordinator
October 2024-Current
As an Injury Benefit Coordinator my focus is on claim handling and resolution. Claim investigation
Into liability, subrogation, compensability, and monitoring compliance. Helping injured workers understand their rights and responsibilities. Educating injured workers on work Injury Vs. Workers Compensation. Communicating with clients, to coordinate care, and assure that benefits are applied and if needed denied correctly in a timely manner. Setting and managing reserves to assure fiscal responsibility. Reporting to appropriate agencies and Plan oversight.
Sr Claim Resolution Representative/ Liberty Mutual
July 2023-July 2024
As a Sr Claims Resolution Specialist my focus was claim resolution. I evaluated the following aspects of a claim: Liability, Medical Necessity, Casualty and resolved the claims in question by discovery using communication with policyholders, witnesses and claimants. I routinely exceeded metrics in loss management, negotiations, policyholder satisfaction, volume, accuracy and knowledge required to adequately provide comprehensive resolution to claims in conflict. I provided individual support to new employees and provided proper feedback.
Senior Claim Specialist / Liberty Mutual
July 2022-July 2023
I addressed and resolved client concerns and provided senior level claim processing within my scope. I obtained and processed valid and correct appraisals for vehicles. I assisted clients with coordination of automobile tows. I continued to exceed metrics in call volume and accuracy and received positive feedback from surveys regarding customer satisfaction.
Claim Intake Specialist / Liberty Mutual
July 2021-July 2022
As a Claim Intake Specialist, I processed basic claim information. This information was obtained from the policyholder. I answered client questions, managed and transferred calls to appropriate departments. Continued to meet and exceed metrics in call volume and accuracy.
Escalations Specialist CSR Level 3 / Wells Fargo
April 2020-July 2021
I received inbound calls from Tier 1 and 2 CSR teams from customers who requested an escalation for their concerns. I used numerous de-escalation techniques to ensure customer concerns were professionally managed and that was reflected in customer satisfaction.
Banker Coach / Wells Fargo
April 2017-April 2020
I effectively trained new hires in an end-to-end model. I performed evaluations in all phases of new hire developments including feedback to new hires and site managers. Determined individual skill levels and initiated plans for improvement on an as needed basis.
Banker / Wells Fargo
November 2015-April 2020
As a banker I managed all aspects of banking including inbound calls and general banking services. I routinely exceeded metrics based on overall performance values.
Education
Diploma-Antioch Alternative Education
National Career Education High School
Phlebotomy Certification
EKG Certification
Skills / Professional
10 Key and Querty Claim Discovery Communication
Microsoft Office Suite Problem-solving Training
Client Focused Metric-minded Team First Mentality
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