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Skills

  • Medical records review for personal injury claims
  • Operational improvement
  • Team management
  • Empathy in Customer Service
  • Documentation accuracy and thoroughness
  • Complex claims investigations
  • Supervision
  • Benefits review
  • Accurate loss assessment and reporting
  • Digitization of claims records

Work Experiences

  • Collaborated with a cross-functional team.
  • Assessed damage from program.
  • Analyzed trends from prior claims to identify cost-saving opportunities, which led to a $14,000 reduction in payouts over the past year.
  • Acted as the liaison between internal departments and external agencies, ensuring cohesive communications and resolving inter-departmental claims issues within two years.
  • Acted as the liaison between internal departments and external agencies.
  • Avoided financial loss to the company of $8.
  • Achieved a 52% accuracy rate.
  • Conducted investigations into complex claims.
  • Achieved a 63% improvement in processing times.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.

Summaries

  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Claim Trainee adept at processing personal injury claims and coordinating with medical professionals, ensuring timely closure of claims within 5 days.
  • Claim Trainee passionate about simplifying the insurance process.
  • Claim Trainee skilled in processing personal injury claims.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Program professional with 4 years of experience evaluating coverage and supervising claims review.
  • Collaborative Claim Trainee.
  • To deliver information to policyholders, makes use of well-developed communication skills.
  • Clear understanding of vendor management and strategic planning as well as vendor management training.
  • Within Miscellaneous, senior Claim Trainee and outstanding performer in process improvement and risk assessment.

Accomplishments

  • Contributed to the creation of a cross-departmental task force aimed at revising internal claims processing procedures, reducing redundancy and cutting average claim processing time by 42%.
  • Worked with external vendors and medical examiners to expedite claim confirmation, reducing average confirmation time by 9 hours.
  • Documented and resolved process which led to category.
  • Devised and implemented a new policy interpretation strategy that improved claimant understanding and resulted in a 51% reduction in payout disputes.
  • Implemented a continuous improvement strategy within the claims department, focusing on eliminating bottlenecks and reducing claim process time by 45%.
  • Reduced average claim settlement time by 15 days through the implementation of a ServiceNow-based tracking system.
  • Collaborated with the CRM team to enhance customer experience, reducing claim-related customer complaints by 47%.
  • Implemented a project management tool across the claims team to track productivity, which resulted in closing 16 claims per day on average.
  • Performed deep dives into denied claims, identifying root causes and contributing to a 56% decrease in unjust denials over 18 months.
  • Proactively monitored legislative changes in Chicago to ensure alignment of claims handling practices with up-to-date compliance standards.

Affiliations

  • Disaster Recovery Institute International (DRI)
  • Continuing Professional Development (CPD) in Insurance Claims & Risk Analysis
  • Professional Association of Healthcare Risk Managers (PAHRM)
  • National Association of Subrogation Professionals (NASP)
  • Jaycees
  • Property Claims Association of Chicago
  • Chartered Insurance Institute (CII)
  • Society of Financial Examiners (SOFE)
  • Lions Club
  • National Association of Public Insurance Adjusters (NAPIA)

Certifications

  • General Claims Adjuster License – Illinois
  • Certified Business Analysis Professional (CBAP)
  • Cisco Certified Network Associate (CCNA)
  • Microsoft Certified Systems Engineer (MCSE)
  • Legal Principles Claims Specialist (LPCS) – initiative
  • Advanced Negotiation Skills in Claims Certification – Cedar Works
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Salesforce
  • Workers' Compensation Claims Professional (WCCP) – procedure
  • SHRM Certified Professional (SHRM-CP)

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