Sales and Service Administration Representative

• 2018 - Present

Benefits Services Representative

• 2017 - 2018

- Provide timely, accurate information in response to member and provider inquiries regarding benefits eligibility, group plan coverage (health/dental/life), claims, and service.- Assess completed claims to determine adjustments required, investigate premium accounting issues, and resolve employment status discrepancies.- Met all production and quality performance targets and was selected for additional uptraining within 6 months.

Claims Examiner

• 2013 - 2017

- Adjudicated credit card and travel insurance claims to determine eligibility based on contract terms (trip cancellation/interruption, baggage loss/delay, collision loss/damage, purchase security, and extended warranty). - In 2015/2016, exceeded production targets by over 20% while exceeding quality targets without overpayments. - Served as leading senior examiner and handled team leader duties as needed, including escalated complaints, legal and social media threats, workflow management, and resource planning. - Trained and onboarded 10 new examiners over 24-month period; delivered in-class instruction and developed comprehensive training material, learning plans, and other operational resources. - Conducted 12-month production data analysis to update staffing model and quantify additional hiring needs. Show less

Claims Analyst

• 2010 - 2012

- Adjudicated health care claims to determine eligibility based on contract terms, specializing in warranty policies and web claims. - Formulated web claims workflow adjustments resulting in team production increases of 100-400%. - Facilitated training for 6 onsite web analysts, independently developed and implemented 60-day support framework, and developed interim knowledge management strategies. - Adjudicated health care claims to determine eligibility based on contract terms, specializing in warranty policies and web claims. - Formulated web claims workflow adjustments resulting in team production increases of 100-400%. - Facilitated training for 6 onsite web analysts, independently developed and implemented 60-day support framework, and developed interim knowledge management strategies.

Team Lead/Trainer

• 2009 - 2010

- Trained new employees and provided technical and soft skills uptraining to all call centre staff.- Designed and wrote quality assurance training manual in collaboration with QA team.- Developed performance assessments and quantified training material for review by Ministry of Training in pursuit of Government of Ontario apprenticeship certification.- Maintained all training manuals, designed new training resources, and facilitated transition to new scoring procedures with training and QA teams. Show less

Bilingual Customer Service Representative

• 2009 - 2009

- Fielded incoming program member inquiries; booked and issued reward tickets.- Processed written communication from program members, resolved within service level deadlines, and responded effectively by adapting template responses.