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Skills

  • Risk management
  • Complex coverage issues
  • Data analysis and reporting
  • Time management and prioritization
  • Ability to read medical records
  • Emerging coverage
  • Microsoft Office
  • Communications
  • Driven
  • Analytical

Work Experiences

  • Calculated quotes and provided information on insurance options to potential clients.
  • Achieved a 64% reduction in cycle times.
  • Mentored a group of 16 new brokers.
  • Achieved a 80% increase in customer satisfaction ratings.
  • Kept patient finances, records, and health statuses confidential.
  • Customer satisfaction was impacted by policy changes and company conditions, which I reported.
  • All premiums were collected on or before the effective date of coverage.
  • Extreme cases were referred to the Special Investigation Unit (SIU) for further investigation.
  • Achieved a 37% customer satisfaction rating.
  • Was able to effectively communicate with members of the operations, finance, and clinical departments.

Summaries

  • Expert at providing insurance coverage advice to current and potential clients, as well as processing applications, payments, and corrections.
  • Experienced metric Insurance Specialist with a track record of managing large caseloads in high-pressure situations.
  • Among his accomplishments is the creation of a metric app for use in the system industry.
  • Excellent written and verbal communication skills, as well as the ability to resolve claims to everyone's satisfaction.
  • Hardworking Bodily Injury Claims Adjuster with 13 years of telecommuting experience meeting customer needs.
  • Motivated Bodily Injury Claims Adjuster with experience managing large-scale projects, including budgeting and administration.
  • Types at a rate of 7 words per minute and is proficient in the use of Asana and Power BI.
  • Working with Agile and Scrum methodologies to meet project milestones within specified timeframes is a strong suit.
  • Able to type at a rate of 5 words per minute and use programs like Adobe Creative Suite and Workday.
  • Licensed Insurance Broker with a working knowledge of new coverage competencies, exclusions, and endorsed enhancements.

Accomplishments

  • Documented and resolved category which led to standard.
  • Documented
  • Reduced
  • Advised
  • Effectively managed a caseload of 11+ catastrophic bodily injury claims while achieving a 48% reduction in overall resolution times.
  • Design: Responsible for creative design for prominent procedure.
  • Business Development: Initiated two key partnerships which resulted in standard revenue growth.
  • Streamlined
  • Guided
  • Resolved product issue through consumer testing.

Affiliations

  • Society of Claims Law Associates (SCLA)
  • Association for Computing Machinery
  • Healthcare Financial Management Association (HFMA)
  • Fraud Claims Law Specialist (FCLS) Designation
  • Association of Information Technology Professionals
  • Society of Insurance Research
  • American Medical Informatics Association
  • Toastmasters
  • American Academy of Forensic Sciences (AAFS) — Best Practices in Medical Records Review
  • National Alliance for Insurance Education & Research

Certifications

  • Medical Bill Review Expert (MBRE)
  • CompTIA Security+
  • Ethical Responsibility in Claims Handling—Certified (ERCH)
  • Framework license
  • Senior Claim Law Associate (SCLA)
  • Associate in Loss Control Management (ALCM)
  • Associate in Claims (AIC)
  • Certified Workers' Compensation Professional (CWCP)
  • Certified Claims Professional (CPCU)
  • Chartered Life Underwriter (CLU)

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