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Skills

  • Customer service
  • Liaison with legal teams for risk mitigation
  • Communications
  • Multilingual communication skills (German)
  • Onboarding and training program design
  • Operational efficiency improvement
  • Team Leadership
  • Staff training and development
  • Cross-department audits
  • Billing and coding discrepancy resolution

Work Experiences

  • Identified insurance coverage limitations with a thorough examination of claims documentation and related records.
  • Gathered and tracked evidence in support of legal processes.
  • Achieved initiative.
  • Analyzed 13 high-priority claims, successfully resolving 71% within company-imposed deadlines.
  • Collaborated with cross-functional teams.
  • Assessed and adjusted claims for compliance regulations, reducing regulatory discrepancies by 29% in 2015.
  • Solved initiative issues, improved operations, and provided excellent customer service.
  • Looked for industry trends on social media and through online sources.
  • Transported Workday to one year customer locations.
  • Achieved a 61% error reduction.

Summaries

  • Adept at identifying billing discrepancies.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Accomplished in regulatory compliance adjustments.
  • Adjustment Specialist skilled at overseeing high-priority claims, resolving 54% within deadlines, and maintaining strong vendor partnerships for long-term success.
  • Achieved optimal handle times.
  • Bringing a proven track record of success in Adjustment Specialist roles throughout a progressive insurance industry career.
  • Astute insurance professional with 9+ years of experience assessing properties, determining liabilities, and negotiating settlements.
  • Accomplished within one fiscal year.
  • Achieved a 62% higher resolution rate.
  • Strengths in data analysis and cross-functional collaboration backed up by Miscellaneous training.

Accomplishments

  • Successfully processed 9 high-priority claims daily, maintaining compliance with industry standards.
  • Conducted thorough root-cause analysis on adjustment errors, presenting data-driven recommendations leading to standard.
  • Led a cross-functional team to improve reconciliation efforts, reducing recurring errors in financial adjustments by 47%.
  • Supported the legal team in resolving adjustment disputes, decreasing potential liability by $17 through timely interventions.
  • Collaborated across departments to resolve coding issues, improving the accuracy of claims submissions by 49%.
  • Resolved product issue through consumer testing.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Revised adjustment workflows for internal teams, reducing error rates by 31% and significantly improving productivity.
  • Analyzed 2 high-priority claims, successfully resolving 64% within company-imposed deadlines.
  • Presented data-driven adjustment reports to executive management, influencing strategic decision-making on resource allocation.

Affiliations

  • International Council of Nurses
  • Society for Human Resource Management (SHRM) Associate
  • Certified Workflow Automation Specialist (standard)
  • Freemason
  • Contract Compliance Monitoring Webinar Series Attendee – 2018
  • Client Portfolio Management Certification through standard
  • Mentor at National Council for Compensation Insurance (NCCI) events
  • Association of Information Technology Professionals
  • Society of Human Resource Management
  • Member of the Chartered Institute of Loss Adjusters (CILA)

Certifications

  • Customer Support Specialist Certification
  • Microsoft Certified Systems Engineer (MCSE)
  • Salesforce
  • Associate in Claims (AIC)
  • Certified Legal Relationship Manager (CLRM)
  • Certified Business Process Professional (CBPP)
  • Adjuster Continuing Education Credit (CEC)
  • Certified Recovery Specialist (CRS)
  • Google Certified Professional Cloud Architect
  • Certified Insurance Consultant (CIC)

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