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Skills

  • Invoice generation
  • Team building
  • Advanced claims audit
  • Problem resolution
  • Fraud identification
  • Fraud detection and prevention
  • Customer service
  • Business operations
  • Time management
  • Attention to detail

Work Experiences

  • Assisted policyholders affected by natural disasters in Atlanta, guiding them to file claims and receive support within the past year.
  • Answered 2 phone calls per several months to assist customers.
  • Achieved a $85,000 reduction in claim processing costs by identifying inefficiencies in the claims workflow.
  • Was in charge of all tasks delegated to me, including process improvement and quality assurance.
  • Used Jira to compile data gathered from various sources.
  • Achieved $12 cost savings per quarter.
  • Achieved results during 18 months.
  • Learned data analysis and quality assurance to help with office needs.
  • Answered an average of 11 calls per 18 months to assist claimants, resulting in a 17% improvement in average handling times.
  • Answered an average of 2 calls per several months.

Summaries

  • Achieved faster claim outcomes for policyholders.
  • Initiative, metric, and category are all available.
  • Achieved Top Performer recognition.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • With hands-on experience, eager to learn new skills and advance knowledge.
  • Achieved a 41% retention rate.
  • Achieved a significant reduction in claims cycle time from several months to two years, enhancing efficiency and raising customer satisfaction by 50%. I thrive in fast-paced, high-stakes environments.
  • Multilingual and fluent in German and Japanese, with a strong grasp of cultural differences.
  • Six Sigma certified
  • A results-driven Claims Customer Care Associate with a history of optimizing workflows and reducing claims processing costs by $32,000, always striving for operational efficiency.

Accomplishments

  • Reduced total claims processing time from the past year to 6 months by retraining team members and introducing new documentation standards.
  • Leveraged conflict resolution techniques to resolve disputes with no further escalation, contributing to an 27% drop in customer complaints.
  • Identified and eliminated bottlenecks in the claims processes, reducing the resolution turnaround time from one year to two years.
  • Analyzed complex claims to detect discrepancies and discrepancies, resulting in a 29% improvement in first-pass claims resolution.
  • Proactively monitored key metrics and KPIs related to the claims process, achieving a 78% improvement in overall service level agreements (SLAs).
  • Improved multichannel customer communication processes, enabling a 31% increase in the speed of resolving email and phone claims.
  • Developed and maintained relationships with external vendors, achieving 30% faster claims responses through a streamlined communication approach.
  • Led claim resolution strategies that reduced overall processing costs by 15%, while maintaining excellent customer service standards.
  • Provided actionable feedback on claims processes, which led to achieving a 69% increase in overall customer satisfaction scores.
  • Resolved claims disputes by investigating discrepancies and collaborating with internal teams, reducing escalations by 20%, improving customer retention.

Affiliations

  • Attendee, Advanced Claims Management Workshops at Austin Academy
  • Certified Claims Professional (CCP) under the International Claims Association (ICA)
  • Attendee, Annual Global Insurance Forum, focusing on digital transformation in claims
  • Active Member, Customer Care Leadership Network (CCLN)
  • Collaborator, Insurance Fraud Prevention Network (IFPN), focusing on claims audit and prevention
  • Member, Insurance Council of the Southwest - promoting claims excellence
  • Participant in Cross-Functional Leadership Program at Chicago
  • Active Participant, Claims and Litigation Management (CLM) Alliance
  • Affiliation, International Claim Association (ICA) - for continuous professional education
  • Affiliate Member, Professional Liability Underwriting Society (PLUS)

Certifications

  • Principles of Risk Management and Insurance – Brightline
  • Chartered Property Casualty Underwriter (CPCU) - The Institutes
  • Cisco Certified Internetwork Expert (CCIE)
  • Six Sigma Green Belt - Cedar Works
  • CompTIA Security+
  • Microsoft Certified Systems Engineer (MCSE)
  • American Academy of Financial Management (AAFM)
  • Fundamentals of Data Analysis for Insurance Claims – Vantage
  • Insurance Data Analyst Certification Cedar Works
  • Certified Insurance Service Representative (CISR) – framework

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