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Skills

  • Relationship building
  • First Aid/CPR
  • Business operations
  • Benefit explanation
  • Building construction knowledge
  • Team management
  • Award-winning sales professional
  • Insurance billing
  • Client relationship management
  • Administrative support

Work Experiences

  • Was in charge of coding claims forms and resolving disputes between carriers and clients.
  • Learned workflow optimization and vendor management to help with office needs.
  • Management recognized me for providing outstanding customer service.
  • Applications, payments, corrections, endorsements, and cancellations were all handled by me.
  • Started it.
  • Guided
  • Advised
  • Solved
  • Did some research.
  • Investigated accidents in order to gather information for developing preventative measures.

Summaries

  • Excellent communicator and team player looking for a position as a QA analyst with a forward-thinking company.
  • Looking forward to taking on a new challenge with a successful team.
  • With 14 years of progressive experience in large-scale corporate banking environments, I am a highly analytical and results-driven banking professional.
  • Dependable and courteous self-starter and team player seeking to apply previous experience to a process position with a forward-thinking organization.
  • Vendor management in program settings and vendor management in strategic planning settings.
  • Well-versed in the creation of insurance policies and terms in order to manage risk and minimize loss.
  • Fluent in both English and Spanish.
  • Determined sales and marketing professional with 6 years of experience in standard industry.
  • Professional with over 7 years of experience in project management and process improvement initiatives across the enterprise.
  • Bilingual Insurance Sales Agent with a knack for driving business development and customer base growth.

Accomplishments

  • Developed a vendor performance scorecard system, enabling data-driven decision-making and reducing late claim settlements by 44%.
  • Provided expertise on regulatory compliance procedures, helping avoid potential legal disputes worth $18.
  • Implemented a claims tracking and reporting dashboard using method, resulting in a 16% improvement in claim processing visibility and accountability.
  • Developed and maintained advanced Excel-based reporting templates for tracking KPI performance across the entire claims lifecycle.
  • Reduced the average cost-per-claim by 3% through strategic vendor negotiations and improved claim resolution processes.
  • Approved policies up to $11.
  • Reduced claim response times by 74% through the development and execution of an optimized claims escalation process.
  • Effectively communicated complex claim details to stakeholders, ensuring alignment on key resolution strategies for high-priority cases.
  • Coordinated with the legal team on complex claims disputes, mitigating potential legal costs worth $4 and ensuring positive outcomes.
  • Managed $15 book of business.

Affiliations

  • Member of the National Association of Professional Insurance Agents (PIA) since 2019.
  • Mentor at the International Institute of Loss Adjusters (IILA), providing professional development resources for new claims professionals.
  • Certified in Senior Claims Manager Program with specialization in fraud detection and prevention, awarded by the International Association of Insurance Professionals (IAIP) in 2022.
  • Active participant in the Claims and Litigation Management Alliance (CLM), engaging in discussions on best practices and emerging trends.
  • Attendee of the annual Insurance Claims Management Conference, gaining insights into industry standards and innovation.
  • Member of the Insurance Regulatory Examiners Society (IRES), focusing on compliance standards in claims management.
  • Attendee of the Annual Fraud and Claims Analytics Conference hosted by the Global Association of Risk Professionals (GARP).
  • Recipient of the Claims Professional of the Year Award issued by the International Claim Association (ICA) in 2019.
  • Regular attendee of the Claims Education Conference, specializing in effective claims intake and communication.
  • Affiliate member of the International Association of Industrial Accident Boards and Commissions (IAIABC) to stay current on workers' compensation claims practices.

Certifications

  • Certified Public Accountant (CPA)
  • Chartered Life Underwriter (CLU)
  • Associate in Insurance Services (AIS)
  • Certified Protection Officer (CPO)
  • Certified Insurance Counselor (CIC)
  • Certified Workers' Compensation Specialist (CWCS)
  • SAP Certified Application Associate
  • CompTIA Network+
  • Advanced Litigation Management Certification - CLM
  • Certified Property & Casualty Underwriter (CPCU) - The Institutes

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