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Skills

  • Customer satisfaction improvement
  • Complex claims management
  • Negotiation and mediation skills
  • Financial forecasting and reserve monitoring
  • Data analysis
  • Organization
  • Team leadership and supervision
  • Adoption of new technologies for insurers
  • Process improvement
  • Coaching and mentorship

Work Experiences

  • Collaborated with cross-functional teams, such as underwriting and legal departments, to resolve complex claims involving system.
  • Corrected policy violations.
  • Designed key performance indicators (KPIs) for claims department staff.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Achieved clearer task assignments.
  • Authored and facilitated claims training workshops that improved team knowledge of Miscellaneous claims policies and updated regulations.
  • Collaborated with legal teams.
  • Championed digital transformation initiatives resulting in a 54% decrease in paper-based claim processing, improving overall efficiency.
  • Authored claims training workshops.
  • Achieved a 68% increase in customer satisfaction by streamlining claims resolution processes and improving communication touchpoints.

Summaries

  • Assistant Claims Manager highly experienced in budget and risk management, recognized for maintaining 17 claims per month with accurate financial planning.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Balanced resolution speed and cost-effectiveness.
  • Achieved customer settlements.
  • Coached junior staff to meet performance KPIs.
  • Assistant Claims Manager is a multi-talented Assistant Claims Manager who is consistently rewarded for planning and operational improvements.
  • Accomplished in coaching junior staff to meet performance KPIs, resulting in overall department efficiency boosts of 25%.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved annual cost savings of $13.
  • Trying to get a similar job with a growing insurance company.

Accomplishments

  • Implemented a structured file management system, allowing the team to increase productivity and shorten resolution times by 9 days on average.
  • Reduced operational costs by $8 annually by negotiating vendor rates based on service requirements and claims process needs.
  • Developed and enforced internal policies that aligned with evolving industry regulations, contributing to a policy compliance improvement of 67%.
  • Documented and resolved program which led to framework.
  • Streamlined natural disaster claims handling process, enabling faster payouts and reducing manual workload by 13 hours per month.
  • Partnered with legal team in resolving complex liability claims, achieving a favorable outcome and minimizing payout exposure by 49%.
  • Collaborated with team of 16 in the development of process.
  • Developed and rolled out a continuous improvement initiative for claims adjudicators, driving a 58% increase in first-time resolution rates.
  • Monitored and evaluated team performance metrics, leading to an improvement in claims closure rate by 73% while decreasing time-to-resolve by 8 days.
  • Proactively identified fraudulent claims, resulting in $16 in savings from successful challenges and recovery efforts.

Affiliations

  • Affiliated with the Workers' Compensation Institute (WCI) for role-specific knowledge
  • American Marketing Association
  • Association for Computing Machinery
  • Certified in Advanced Mediation Techniques from Lakeside Partners
  • American Society of Safety Professionals
  • International Association of Administrative Professionals
  • Member of the Insurance Regulatory Examiners Society (IRES)
  • Certified Professional, Chartered Property Casualty Underwriter (CPCU)
  • Completed Risk Management coursework under Brightline, focusing on claim settlement optimization
  • Participant in Annual Meetings of the Association of Public-Sector Claims Managers (APSCM)

Certifications

  • Microsoft Certified Systems Engineer (MCSE)
  • Ethics in Claims Practice Certification (Ironclad Systems)
  • Certified Professional in Fraud Management (Beacon Labs)
  • Registered Professional Adjuster (RPA) Certification - 2015
  • Leadership Development Program for Claims Managers (Meridian, 2023)
  • Certificate in General Insurance (Cert CII) - 2016
  • Financial Risk and Insurance Claims Certification (Boston, 2017)
  • CompTIA Network+
  • Lean Six Sigma Green Belt for Claims Process Optimization (Cedar Works, 2019)
  • Digital Claims Transformation Specialist (Tableau, 2024)

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