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Skills

  • Budgets
  • Workflow Optimization
  • Stakeholder management
  • Data analysis using ServiceNow
  • Error Reduction Strategies
  • Negotiation skills
  • Collaboration with management
  • Organization
  • Claims Documentation Review
  • Claims Processing

Work Experiences

  • Addressed issues ahead of submission deadlines.
  • Achieved results in three years.
  • Analyzed incoming adjustment requests.
  • Solved standard issues, improved operations, and provided excellent customer service.
  • Achieved a 17% reduction in internal escalations.
  • Collaborated with customer service and finance.
  • Achieved more accurate claim resolutions.
  • Authored detailed adjustment reports for senior management.
  • Adjusted customer billing.
  • Answered 8 calls per several months to help customers with their questions and concerns.

Summaries

  • Achieved a 42% boost in retention.
  • By applying all policies fairly, she is adept at balancing business and customer interests.
  • Achieved a 35% reduction in adjustment errors.
  • Costs were consistently reduced while profits were increased.
  • Committed to customer satisfaction, resolved 77% of escalated cases promptly, driving improvements in overall client retention and company reputation.
  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Achieved a 15% success rate in resolution.
  • Excellent communication skills as evidenced by 10 years of experience interviewing experts, witnesses, and claimants in order to compile data.
  • Insurance adjuster who investigates and analyzes liability in the event of a personal, casualty, or property loss.
  • Achieved error-free processing.

Accomplishments

  • Prepared and presented claims adjustment performance reports to senior management, outlining areas for improvement across the department.
  • Partnered with IT to troubleshoot and optimize the functionality of claims adjustment tools, reducing system downtimes by 37%.
  • Facilitated knowledge-sharing workshops for adjustment representatives, resulting in a team-wide 77% improvement in claims accuracy.
  • Utilized claims management software to streamline adjustment processes, resulting in a 16% decrease in processing times.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Authored adjustment review guidelines that were adopted across the department, leading to a standardized process and a 70% increase in operational accuracy.
  • Designed a reconciliation process that resulted in a $4 reduction in outstanding claims-adjustment tasks.
  • Recovered over $8 in adjustment discrepancies by identifying gaps in the billing cycle and amending customer records accordingly.
  • Led a team responsible for resolving customer billing discrepancies, reducing escalations by 80% over 6 months.
  • Documented and resolved method which led to category.

Affiliations

  • Rotary International
  • Insurance Accounting & Systems Association (IASA)
  • American Medical Informatics Association
  • Claims and Litigation Management Alliance (CLM)
  • Project Management Institute
  • Association of Professional Insurance Women (APIW)
  • Society of Insurance Claims Professionals (SICP)
  • Society of Women Engineers
  • Association of Information Technology Professionals
  • Certification in Risk Management Assurance (CRMA) 2024

Certifications

  • Certified Professional Privacy Engineer (CPPE) from Northwind
  • Fundamentals in CRM Software Management Certification
  • Certified Public Accountant
  • Consumer Handling and Account Adjustment Certification
  • Certified Regulatory Compliance Manager (CRCM)
  • Apple Certified Associate (ACA)
  • Certificate in Conflict Resolution and Mediation
  • Certified Professional in Commercial Claims (CPCC)
  • Certified Customer Service Representative (CCSR)
  • Six Sigma Green Belt Certification for Process Improvement

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