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Skills

  • Complex claims resolution
  • Legal and regulatory adherence
  • Customer Relationship Management (CRM)
  • Project organization
  • Customer service
  • Team building
  • Process optimization
  • Customer de-escalation techniques
  • Claims documentation accuracy
  • Claims intake procedure development

Work Experiences

  • Communicated policy limitations with clarity to avoid misunderstandings and reduce potential legal disputes by 59%.
  • Provided primary customer support to internal and external customers in a fast-paced environment.
  • Kept track of all pending authorizations to resolve discrepancies and avoid revenue loss.
  • Used cross-selling and upselling techniques to increase referral retention rates and increase sales and profits.
  • Shared my knowledge and expertise with coworkers in order to raise employee awareness and productivity.
  • Collaborated with fraud investigation units to identify and report fraudulent claims, saving the company approximately $6 annually.
  • Achieved a 48% reduction in resubmission rates.
  • Achieved in 2021.
  • Collaborated with product teams to enhance claims offerings based on customer feedback, resulting in 12 new service improvements.
  • Boosted customer satisfaction by 34%.

Summaries

  • Boosted policyholder satisfaction by 61%.
  • Claims Customer Service Associate with 16 years of successful client relations and team leadership experience.
  • Bringing 6 years of insurance experience to the table.
  • Achieved a 78% customer retention rate.
  • Achieved closure targets regularly.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Dynamic Claims Customer Service Associate with initiative insurance industry experience servicing policyholders and claimants.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Offering 10 years of experience as well as the willingness to take on any challenge.

Accomplishments

  • Collaborated with team of 17 in the development of metric.
  • Handled a monthly average of 9 customer inquiries, improving claim processing times by 41%.
  • Collaborated cross-departmentally with underwriting, legal, and fraud teams to improve case closure efficiency by 37%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Managed claim requests and reduced the pending claim backlog by 32% through continuous workflow evaluation and load balancing.
  • Collaborated with external partners including legal counsel and title companies to resolve claims disputes efficiently, reducing resolution time by 21%.
  • Trained and onboarded 12 new team members to adhere to claims processing policies, reducing error rate by 27% in the first two years.
  • Identified and escalated systemic claim issues, working with IT and claims support to implement fixes, reducing logged complaints by 25%.
  • Administered claims for Adobe Creative Suite insurance, ensuring consistent accuracy in aligning settlements with policy coverage guidelines.
  • Prepared weekly claims reports for upper management, offering insights that facilitated a 50% increase in operational efficiency.

Affiliations

  • Society of Women Engineers
  • National Association of Insurance Commissioners (NAIC)
  • Insurance Information Institute (III)
  • Project Management Institute
  • Compliance and Ethics Professionals Association (SCCE)
  • Property and Casualty Insurance Claim Managers Group
  • Insurance Customer Service Excellence Forum
  • National Institute of Adjusting Professionals (NIAP)
  • American Institute For Chartered Property Casualty Underwriters (AICPCU)
  • National Association of Social Workers

Certifications

  • Certified Claims Professional (CCP) - Beacon Labs
  • National Association of Health Underwriters (NAHU) Certification Summit Group
  • Certified Public Accountant
  • First Aid/CPR Certified
  • Apple Certified Associate (ACA)
  • Certified Trainer in Insurance Software Tableau Vantage
  • Salesforce
  • Insurance Claims Adjuster Certification Ohio
  • SHRM Certified Professional (SHRM-CP)
  • Google Certified Professional Cloud Architect

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