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Skills

  • High-value claims analysis
  • Project management skills
  • Data analysis
  • Advanced negotiation techniques
  • Compliance with industry regulations
  • Customer Satisfaction Enhancement
  • Data-driven decision making
  • Vendor relationship management
  • Organization
  • MS Office

Work Experiences

  • Collaborated across departments to reduce customer claims processing cycle time by 66%, improving overall satisfaction.
  • Coached and mentored junior staff, increasing claim resolution accuracy by 47% over 2023 period.
  • Investigated, evaluated, and adjusted multi-line claims in accordance with standards and laws.
  • Achieved 10% client satisfaction.
  • Achieved a 82% improvement in claims processing speed.
  • Achieved a 58% win rate.
  • Conducted thorough case analysis.
  • Coached and mentored junior staff.
  • Collaborated across departments.
  • Completed settlements in three years.

Summaries

  • Assessed and improved departmental workflows.
  • Achieved favorable settlements.
  • Achieved a 15% decrease in processing errors.
  • Achieved a 34% faster claims resolution rate.
  • Bi-lingual Claims Manager with over 15 years of leadership experience, recognized for improving claims outcomes through streamlined communication and teamwork.
  • Adaptable manager with a passion for cross-functional collaboration, having reduced reporting times by 34% hours with a streamlined claims reporting system.
  • Adaptable manager with a passion for collaboration.
  • Accomplished in building claims auditing programs.
  • Achieved 19% win rates in disputed cases.
  • Trying to get a similar job with a growing insurance company.

Accomplishments

  • Created a real-time claims approval system that improved client response rates while cutting down approval time by 63%.
  • Streamlined claim adjudication processes by reducing turnaround time by 46% through optimization of workflows.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Drove a data-focused approach to analyzing customer complaints, reducing escalations by 85% and improving resolution time.
  • Implemented a claims escalation procedure that resolved 11 complex cases within record-breaking timelines.
  • Successfully managed the introduction of new claims management software, resulting in a 44% reduction in manual claim rework.
  • Headed the initiative to migrate the claims department's data to the cloud, securing a 24% reduction in data processing costs.
  • Designed and implemented a customer loyalty program that improved repeat claim filing ease, boosting overall client retention by 74%.
  • Developed and launched employee training programs focused on claims handling and fraud detection, improving overall team performance by 31%.
  • Monitored claims performance using KPIs, resulting in the team achieving a 48% improvement in overall throughput.

Affiliations

  • Rotary International
  • Association of Insurance Compliance Professionals (AICP)
  • Society of Women Engineers
  • American College of Coverage Counsel (ACCC)
  • National Association of Professional Insurance Agents (PIA)
  • Project Management Institute
  • Institute of Risk Management (IRM)
  • National Association of Subrogation Professionals (NASP)
  • Lions Club
  • National Insurance Crime Bureau (NICB)

Certifications

  • Certified Professional in Commercial Insurance (CPCI)
  • Associate in Reinsurance (ARe)
  • Performance-Based Claims Certification Brightline
  • CompTIA Network+
  • Insurance Regulatory Compliance Certificate
  • Google Certified Professional Cloud Architect
  • Associate in Personal Insurance (API)
  • CompTIA A+ Technician
  • ServSafe
  • Licensed Insurance Adjuster Texas

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