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Skills

  • Investigation Management
  • Building construction knowledge
  • Customer-Centric Communication
  • Claims processing automation tools (Power BI)
  • RFI Scanners
  • Decision-making under pressure
  • Cross-functional team collaboration
  • MS Office
  • Claims data analysis and reporting
  • Organization

Work Experiences

  • Looked over policies to see what levels of coverage were appropriate and to help with approval or denial decisions.
  • Management recognized me for providing outstanding customer service.
  • Adjudicated 5 claims for property damage per one year, maintaining compliance with both state and federal regulations.
  • Used HubSpot to compile data gathered from various sources.
  • Achieved a 78% drop in legal costs for disputed claims.
  • Achieved a 17% reduction in customer complaints.
  • Provided exceptional customer service to all clients by effectively communicating information and actively listening to concerns.
  • Learned quality assurance and budget management to help with office needs.
  • Collaborated closely with team members to meet project deadlines, develop solutions, and deliver project requirements.
  • Answered 15 phone calls per one year to assist customers.

Summaries

  • Communicative and team-oriented, with QuickBooks expertise.
  • Working with stakeholders and corporate teams is a breeze for this strong relationship builder.
  • With over 17 years of experience reviewing claims and determining coverage, I am highly trained and successful.
  • Achieved 61% reduction in claims backlog.
  • Achieved 61% error reduction.
  • With hands-on experience, eager to learn new skills and advance knowledge.
  • Associate Claims Examiner and team leader with 16 years of experience in process settings.
  • Accomplished in utilizing negotiation strategies to save $18 annually while delivering fair and swift settlements to policyholders.
  • Adept at assessing intricate claims.
  • Expert in program with a strong aptitude for implemented and improved.

Accomplishments

  • Identified fraudulent claims early in the process, saving the company an estimated $2 in 2015.
  • Developed and implemented a claims triaging system that reduced processing time for high-priority cases by 78%.
  • Streamlined vendor management process, reducing vendor expenses by 42%, which contributed to a total claims cost reduction by $5 in 2018.
  • Supported fraud detection initiatives, uncovering 2 high-value fraudulent claims, leading to a $12 reduction in claims payout.
  • Led training sessions for staff on the implementation of new claims technology, resulting in an overall efficiency boost of 81% across the department.
  • Collaborated with the IT team to design and implement claim reporting tools, improving claims-related documentation time by 61%.
  • Developed best practices for reserve management, achieving a 63% accuracy in reserve setting and preventing over-estimations.
  • Introduced QuickBooks, a claims automation software, which increased accuracy and lowered processing times by 77%. This enabled a 21% increase in team productivity.
  • Enhanced customer satisfaction by implementing a customer dispute resolution system that improved response times by 16%, resulting in higher post-claim surveys.
  • Led efforts to implement continuous process improvements that reduced average claim cycle time by 67%. Resulted in a cost savings of $12 annually.

Affiliations

  • Volunteer, Insurance Crisis Management Volunteer Task Force, 2018
  • Certification Holder, Certified Information Privacy Professional (CIPP), 2024
  • Professional Risk and Insurance Management Society (PRIMR) Membership
  • Active Membership, International Association of Claims Professionals (IACP)
  • Member, Healthcare Claim Association (HCA)
  • Participant, Insurance Information Institute (III) Seminars
  • Participant, Claims Leadership Forum & Executive Roundtable, Seattle, 2015
  • Affiliate, Property Casualty Insurers Association of America (PCIAA)
  • Member, Society of Casualty Claims Adjusters (SCCA)
  • Certified Professional in Insurance Regulation (CPIER), 2022

Certifications

  • Certified Data Analyst – QuickBooks
  • Certified Customer Service Professional (CCSP) - Meridian
  • Certificate in Advanced Claims Handling Strategies
  • CompTIA Security+
  • Certified Customer Complaint Resolution Specialist (CCCRS)
  • Catastrophic Claims Response Specialist (CRSS)
  • Lean Six Sigma Green Belt Ironclad Systems
  • Cisco Certified Network Associate (CCNA)
  • Apple Certified Associate (ACA)
  • Association for Project Management (APM)

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