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Skills

  • Technical reporting
  • Communications
  • Process improvement
  • Project organization
  • Customer satisfaction measurement
  • Process optimization
  • Negotiation and mediation skills
  • Supervision
  • Advanced Microsoft Excel
  • Organization

Work Experiences

  • Decreased dependency on external consultants.
  • Contributed to a 28% year-over-year revenue increase.
  • Automated claims analysis.
  • Collaborated with vendors and medical professionals to resolve Power BI injury claims, achieving outcomes within category.
  • Achieved a 61% decrease in fraudulent claim submissions.
  • Assessed liability in large commercial claims, coordinating with legal teams to close 61% of cases with minimal legal exposure.
  • Built and managed a claims knowledge database.
  • Boosted team performance by 80%.
  • Achieved faster claim resolution.
  • Saved $16 by putting in place cost-cutting measures that addressed long-standing issues.

Summaries

  • Achieved year-over-year cost savings of $4.
  • Adept at risk mitigation.
  • Conducted reporting to identify trends.
  • Claims Consultant with 3 years of successful performance reporting and workflow optimization experience.
  • Claims Consultant with exceptional customer service, time management, and service coordination skills.
  • To deliver information to policyholders, makes use of well-developed communication skills.
  • Accomplished Claims Consultant with extensive experience managing 2 claims per one year and maintaining a consistent closure rate above target goals.
  • Consistently tracked claims processes.
  • Creative problem-solver.
  • Achieved 14% favorable outcomes.

Accomplishments

  • Streamlined claims settlement workflows, saving the company 12 in operational costs, enabling faster closure of 11 claims over 2016.
  • Reduced claims processing time by 29% through the introduction of an automated claims management system.
  • Worked closely with legal teams to resolve complex liability cases, closing 15% without litigation.
  • Facilitated a cross-functional project that resulted in 32% faster response times for high-priority commercial claims.
  • Prepared and presented claims risk analysis reports for senior management, resulting in new board-approved mitigation strategies reducing potential losses by 16.
  • Improved cross-departmental communication during catastrophe response, leading to a 80% reduction in customer complaints.
  • Developed a successful appeals process that overturned unfavorable decisions for 51% of claimants, preserving initiative in earnings.
  • Identified trends in claim filings that led to the development of a new risk mitigation protocol, reducing overall claim payouts by 40%.
  • Led the claims department to exceed service-level agreements by achieving claims resolution times 23% faster than industry standards.
  • Created claims reports for metric, improving analytical insight into performance trends and reducing overpayment trends by 52%.

Affiliations

  • Association of Governmental Risk Pools (AGRiP)
  • Society of Actuaries - Risk Management Section
  • Rotary International
  • International Association of Special Investigation Units (IASIU)
  • National Association of Mutual Insurance Companies (NAMIC)
  • Association of Information Technology Professionals
  • Association for Supply Chain Management (APICS)
  • American College of Financial Services - Chartered Financial Consultant (ChFC)
  • National Flood Insurance Program (NFIP) Certification
  • Association for Computing Machinery

Certifications

  • Salesforce
  • Project Management Professional (PMP)
  • Certified Fraud Examiner (CFE) - system
  • ServSafe
  • Certified Public Accountant
  • Microsoft Certified Systems Engineer (MCSE)
  • Property & Casualty Insurance License - Oregon
  • Lean Six Sigma Green Belt Beacon Labs
  • ISO 31000 Risk Management Certification – Northwind
  • Claims Data Analytics Certification - Meridian

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