Customer Service Manager
Resume:
Cynthia Cruz
Brandon FL, *3510
I am looking for a challenging career opportunity with increasing responsibilities in a high performance environment, utilizing my solid decision making expertise, diversified work experience, excellent interpersonal skills, and the willingness and ability to learn.
I am bilingual, can read, write and translate Spanish to English and English to Spanish. I have strong organizational, communication and listening skills and an ability to prioritize and multi-task. I have strong problem solving and decision making skills. I am able to work independently in a high technical and fast paced environment and make decisions based on knowledge and expertise. I am able to pay attention to detail and document efficiently and completely. I am a team player, assertive and am able to adapt to change with a caring, helpful and respectful attitude.
Qualifications:
AmeriLife Insurance Administrators - Clearwater, FL 07/10 to 06/11
Medicare Supplement Underwriter
• Evaluated all Underwriting risks and activities within the company’s guidelines and procedures.
• Completed on line search of prescribed medications using Intelliscript based on carrier’s request, the applicant’s state of residence, and utilizing the carrier’s vendor of choice.
• Responsible for conducting an average of 20-25 telephone interviews per day using a script that matched the questions on the application, including all bilingual calls both outbound and inbound verifying medical history and medications.
• Documented all interviews into the company’s system. Responsible for data entry of all applications.
• Processed all approvals, declines by adding medical ICD coding numbers, withdrawals including notifying applicant by letter, with copy to agent and applicant’s file.
• Canceled Medicare Supplement policies as requested by applicant or agent, and verified the accuracy of insurance company records.
• Trained and mentored new employees in the Underwriting guidelines and process of Medicare Supplement policies. Developed workflow for new employees as a training tool for accomplishing goals, and organized team meetings to go over any questions or concerns regarding the underwriting process.
• Responsible for translating documents from English to Spanish.
• Administered customer service to all applicants and agents on a daily basis.
• Responsible for accurate data entry and file keeping in order to ensure audit compliance.
• Responsible for Clerical office support including, file processing, faxing, scanning, copying, printing of documents and answering phones.
Citrus Health Care - Tampa, FL. 10/08 to 10/09
Medical Underwriter
• Evaluated complicated and in depth applications for new business, renewals and certain endorsements for acceptability in accordance with company guidelines and standards, utilizing underwriting and risk management techniques.
• Approved and rejected risks and/or structure coverage within approved authority level, as well as performed transactions according to the latest Underwriting manual, standards, rates, guidelines and procedure using consistent and efficient risk-based underwriting principles.
• Initiated action to cancel a policy and modified coverage with efficient risk-based underwriting.
• Requested medical records such as Para meds and prescription records using Intelliscript to properly assess the risk and added debits as necessary.
• Researched and resolved concerns with both internal and external customers interacting via phone and/or in writing and, when needed, provided recommendations to Underwriting Manager to resolve cases.
• Evaluated all underwriting appeals with the underwriting manager, provided support to management on reports and workflow issues, and in the training and development of staff.
• Supervised staff in absence of underwriting manager.
• Worked with Manager to establish or amend underwriting procedures based on changes to underwriting manuals, rates, guidelines and procedures.
• Clerical support including (faxing, scanning, copying, printing, of documents and answering phones.)
• Responsible for proper data entry and file keeping to ensure audit compliance.
• Coordinated and scheduling of facilities for attending meetings for Manager.
• Worked with the Director of the Commercial Product in developing the PNP’s for URAC accreditation.
• Involved with Ingenix Actuarial Consulting firm in developing the new individual plans.
• Provided underwriting advice to agents, staff based on the latest corporate manuals.
• Handled Individual Commercial Agent Commissions.
• Worked on special projects and duties as assigned by the Director.
Health Plan Services - Tampa, FL. 07/06 to 08/08 Medical Underwriter
• Reviewed all Group and Individual Health and Dental applications.
• Reviewed medical, dental enrollment applications in accordance with carrier’s medical and administrative guidelines and standards.
• Knowledge of Major Medical Underwriting with the use of the Milliman rating system, MIQ (Medical Information Questionnaires), path reports and field manuals.
• Prepared all new business for issuance and analyzed documentation or additional information as needed to make sound underwriting decisions.
• Accepted and declined risks within specific, defined levels of authority and/or refer to manager for additional review with appropriate information required for decision.
• Reviewed, issued and inputted all Health and Dental application information into the TAS system.
• Was responsible for establishing and maintaining relationships with agencies within the territory as well as effectively communicated and interacted with different levels of internal/external customers. Provided excellent customer service to clients, agents, sales team and contacts.
• Effectively communicated required changes and notifications to the agent, business specialist and sales team.
• Assisted management in daily workflow and reports in Supervisor’s absence.
• Assisted in the coordination of underwriting activities, such as project planning and processes.
• Engaged in programs to increase proficiency in present position and advancement within the company.
Sagicor International Management Services - Tampa, FL 12/01 to 07/06 Underwriter
• Reviewed all International Individual Health and Group applications using the carrier’s guidelines.
• Processed all Individual and Group Health reinstatements, add dependents, reduce deductibles and transfers.
• Created Underwriting New Business reports for President and underwriting manager.
• Created and issued premium notices, annual policy reports, termination and lapse notices, re-insurance reports.
• Prepared new business for issuance, analyzed available documentation and gather additional information as needed to make sound underwriting decisions.
• Reviewed referrals from underwriting assistants.
• Effectively communicated required changes and notifications to insured and agents.
• Provided excellent customer service to insured’s and customers both internal and external. Reviewed requests for special endorsements and additional coverage’s.
• Forwarded case approvals to broker/contact, sending them via e-mail and mail an approval letter.
• Maintained company manuals and review company correspondence to keep abreast of technical revisions, modifications, enhancements or changes in current procedures.
• Assisted in the coordination of the underwriting activities and training processes as needed.
• Was responsible for supervising and training the team in the Underwriting procedures making sure that they were detailed oriented, possessed interpersonal skills and a willingness to learn.
• Made travel, hotel and transportation arrangements.
• Responsible for scheduling and coordinating of facility for attending meetings for Manager.
• Maintained and ordered all supplies for office use.
• Data entry of all correspondence
• Responsible for reservations of out of state airfare/hotel accommodation.
Paramount Dental Insurance Plan Inc. - Tampa, FL 07/00 to 09/01
Marketing Coordinator/Administrative Assistant
• Processed group/individual dental enrollment applications.
• Reviewed integrity of Membership standing and of enrollment listing.
• Submission of dental membership cards to active members.
• Prepared disenrollment memberships from Dental plan.
• Provided membership changes to the Dental plan.
• Prepared agent enrollment kits for the Vice-President/Upper, managerial staff.
• Prepared mass mailing for agents/subscribers and providers.
• Provided general administrative duties for Vice-President and Upper managerial staff.
• Assisted in the preparation of USF ALUMNI ASSOCATION mailings.
• Assisted director of marketing with the preparations and conducting of Bilingual enrollment meetings.
• Worked closely with Bilingual agents in understanding company policy.
• Resolved agent’s complaints by providing assistance as needed.
• Served as interpreter for Vice-President when dealing with bilingual providers and agents.
• Assisted agents in obtaining appropriate materials for enrollment meetings.
• Updated and reviewed Master Agent listing for Vice-President.
• Coordinated agenda to meet the weekly work schedule for Vice-President.
• Assisted receptionist with inbound calls as needed.
• Prepared courier documentations for mailings.
Volunteer to Nicaragua Township of Managua - Managua Nicaragua 08/99 to 06/00
Bilingual Instructor
• Taught English with bilingual instruction including grammar.
• Taught elementary level mathematics.
• Taught general Hygiene.
• Taught computer basic/introductory level.
American National Insurance Company - Brandon, FL 03/99 to 08/99
Contact Manager for Auto/Home Insurance
• Acquired and developed new contracts via effective and demanding telemarketing resources including but not limited to external marketing sources and indexes.
• Created marketing plans with agents.
• Obtained list and scheduled appointments to follow up with prospective clientele.
• Maintained database for company.
• Coverage of inbound telephone calls.
• Data entry of claims and quotes for home and auto insurance.
The Guardian Life Insurance of America
Senior Contract and Licensing Administrator New York, NY 10/97 to 02/99
Junior Field Administrator Assistant New York, NY 10/95 to 09/97
Senior Secretary New York, NY 06/94 to 10/95
Receptionist New York, NY 11/93 to 06/94
• Prepared all necessary paperwork, contracts licenses and file accordingly for data entry onto FAS system and Appoint Pac software for State appointment.
• Data entry of all amendments to producer contracts, license broker’s contracts and licenses.
• Any and all changes that amend producer status, State licenses authority, deceased producers and corporate merges.
• Completed manuals via Appoint Pac program, and state specified appointment forms, along with required documentation.
• Checked for fees so as to have producers properly appointed to transact business for the company.
• Annotated appointments upon approval by State Insurance Department.
• Very heavy communication with agency personnel, home office, associates and field producers regarding status of contracts, licensing via telephone, GEMS speed memos and fax.
• Assisted, as needed to help expedite the flow of operations of the department.
• Interpreted and prepared General Agent, CDS and DIS contracts.
• Prepared and distributed General agent termination notices.
• Liaison for regional Vice President and their staff.
• Typed charts and correspondence for agency Vice President
• Assisted agency administrator with tasks as assigned.
• Maintained and updated files on a weekly basis.
• Distributed daily and monthly reports to home office and field personnel.
• Answered telephones for department and directed callers to the appropriate parties.
• Responsible for preparing and typing reports, correspondence, forms as requested.
• Greeted and signed up all visitors and directed them to appropriate parties.
• Utilized GEMS system for communication to and from appropriate agencies.
• Performed new business status services for agencies not in system.
• Prepared welcome letters for new FR’s as well as follow up letters to Inspection Company for new hires.
• Responsible for travel, hotel and transportation arrangements for Supervisor.
• Responsible for all clerical support including faxing, scanning, copying, printing of all documents and answering phones.
• Was responsible for greeting General Agents and all visitors and escort them to the appropriate parties as well as alert appropriate secretaries of their arrival.
• Assisted agency home office staff with clerical duties, sorting mail for entire department
• Contacted mailroom, supply department, and print shop on a daily basis.
• Was responsible for the photocopier machines and ordering supplies.
Certificates: PL 2-15 – Life, Health and Variable Annuity, HIPPA Regulations
Education: Harry S. Truman High School – Bronx, New York
Betty Owens Business Academy – New York, NY
Discovery Center - New York, NY
SKILL: Bilingual English/Spanish (Read/Write/Translate), Knowledge of Medical Terminology, Microsoft Word, Excel, Outlook, Internet Explorer, Bosa Nova System, Administrative Support, Customer Service, Licensing and Contracting, Facsimile, Printer, Scanner, Multiline Phone
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