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Skills

  • Policy coverage expert
  • MS Office
  • Report writing
  • Xactimate specialist
  • Trend analysis
  • Business operations
  • Proactive team player
  • Key Performance Indicator (KPI) Monitoring
  • Premium financing
  • Problem resolution

Work Experiences

  • Evaluated leads obtained through cold calling, lead databases, and direct referrals.
  • Promoted ancillary products to 6 existing and new customers each month.
  • Processed 18 invoices and mailed documentation to clients each the past year.
  • Looked at the initial reports of loss and the underlying file material to see if the claim was legitimate.
  • Worked with the claims department and industry anti-fraud organizations to resolve claims.
  • Worked closely with law enforcement and testified in criminal cases.
  • Met with potential customers and business owners in homes, businesses, and other settings.
  • Worked with others to brainstorm new process possibilities.
  • Was in charge of maintaining a suspicious claims database and preparing quarterly reports for supervisors.
  • Answered 17 phone calls per one year to assist customers.

Summaries

  • Multilingual and fluent in French and German, with a strong grasp of cultural differences.
  • Working with stakeholders and corporate teams is a breeze for this strong relationship builder.
  • Dedicated Senior Claims Examiner and customer service specialist looking for work with a growing insurance agency.
  • Communicative and team-oriented, with Power BI expertise.
  • Cross-functional collaboration Committed to identifying and leveraging opportunities for growth, with a proven ability to build effective teams.
  • OSHA certified
  • Strategic thinker with expertise in workflow optimization.
  • Category are well-understood.
  • Senior Claims Examiner with stakeholder engagement and team leadership abilities.
  • Licensed Insurance Broker with a working knowledge of new coverage competencies, exclusions, and endorsed enhancements.

Accomplishments

  • Developed a claims reconciliation process that saved the company an estimated $18 annually by reducing payment errors.
  • Protective Services: Applied safety procedures and policies as outlined in Department Safety Manual.
  • Reduced
  • Analyzed financial data of high-volume claims exceeding $18, optimizing payment strategies that minimized losses by 42%.
  • Streamlined
  • Trained
  • Prepared
  • Process Improvement: Created new departmental procedures manual. Assessed organizational training needs.
  • Initiated
  • Received the “President’s Club” award for 17 consecutive years for outstanding sales performance.

Affiliations

  • Member, National Association of Insurance Commissioners (NAIC) process
  • Participant, National Conferences on Insurance Fraud Prevention 2016, presenting a workshop on strengthening fraud detection systems
  • Founder and Chair, Vantage Claims Leadership Development Program, focused on mentoring future examiners
  • Founding Member, 2016 Claims Examiner Peer Review Network, focused on evaluating high complexity cases for accuracy and fairness
  • Board Member, Insurance Claims Awareness Association (ICAA) 2022, influencing educational topics for national conference
  • Volunteer, Pro Bono Claims Support Team 2019, providing assistance during high-catastrophe seasons
  • Speaker, Claims Settlement Educational Symposium 2018, training professionals on optimizing customer service during settlements
  • Panelist, Regional Fraud Investigation Collaborative 2019, focused on best practices for multi-industry fraud detection networks
  • Fellow, Life Management Institute (FLMI), certification focused on life insurance adjudication best practices 2024
  • Mentor, Claims Examiner Certification Pathway, 2022, guiding junior examiners in achieving certification in method

Certifications

  • Google Certified Professional Cloud Architect
  • Associate in Risk Management (ARM)
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Business Analysis Professional (CBAP)
  • Fraud Claims Law Specialist (FCLS)
  • Multiline Claims Adjuster Program (MLCAP)
  • Digital Claims Transformation Certification (DCTC)
  • Health Insurance Associate (HIA)
  • Certified Insurance Examiner (CIE)
  • Chartered Property Casualty Underwriter (CPCU)

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