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Skills

  • Claims Process Optimization
  • Corporate Communications
  • Dispute resolution
  • Claims software implementation (Asana)
  • Procedure equipment
  • Coverage determination
  • Team building
  • Benefits review
  • Cost-per-Claim Reduction
  • Claims Auditing

Work Experiences

  • Collaborated with the technology team.
  • Achieved a 85% increase in on-time settlements.
  • Achieved no fines or violations during two years.
  • Created self-service platforms.
  • Boosted team productivity by 16% through the introduction of regular performance coaching sessions and targeted development plans.
  • Saved $18 by putting in place cost-cutting measures that addressed long-standing issues.
  • Successfully negotiated the resolution of disputed bills or invoices totaling up to $14.
  • Transported Adobe Creative Suite to one year customer locations.
  • Collaborated with the technology team to create self-service platforms that improved customer engagement by 49% over the past year.
  • Collaborated with multiple departments.

Summaries

  • Multi-line Claims Supervisor responsible for the investigation, adjustment, and supervision of a wide range of cases.
  • Collaborative Claims Director recognized for working cross-functionally with the technology team to build self-service claims platforms, improving customer engagement by 67%.
  • Claims Director with 6 years of successful process improvement and team leadership experience.
  • Collaborated efficiently with external legal counsel.
  • Achieved substantial savings over a 6 months period.
  • Collaborative Claims Director recognized for building high-performing teams, delivering 64% improvement in key performance metrics, and advancing team competence through coaching.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the metric business.
  • Trains and mentors employees to ensure that policies, procedures, and applicable laws are followed.
  • Achieved competitive advantage.
  • Bringing 15 years of experience in the field, as well as superior team leadership and data analysis abilities.

Accomplishments

  • Directed multi-departmental training, improving adherence to updated claims policies and lowering compliance deviations by 85%.
  • Led comprehensive market research for competitor claims processes, introducing best practices that resulted in an operational cost decrease by $10.
  • Coached claims examiners and analysts, resulting in a 55% increase in first-pass resolution rates within 2015.
  • Built a cross-departmental communication platform yielding a 42% increase in claims accuracy and a reduction in settlement delays.
  • Identified and corrected over 7 internal compliance issues, securing a 38% increase in regulatory satisfaction.
  • Played key role in managing catastrophic events that scaled up claims handling capacity by 22% during method, ensuring disaster claims were processed within 4 weeks.
  • Reduced claims expenses by 18% through targeted negotiations, vendor management, and reviewing fraudulent claims.
  • Implemented continuous training programs for 3 claims handlers, improving policy comprehension and reducing staff churn by 68%.
  • Revamped appeals and grievance processes, improving customer satisfaction rates by 25% while aligning with regulatory timelines.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Institute of Risk Management (IRM)
  • International Association of Administrative Professionals
  • Association of Certified Fraud Examiners (ACFE)
  • Association of Claims Professionals (ACP)
  • American Marketing Association
  • International Association of Special Investigation Units (IASIU)
  • Risk and Insurance Management Society (RIMS)
  • American Medical Informatics Association
  • Society of Actuaries (SOA)
  • National Alliance for Insurance Education & Research

Certifications

  • Accredited Claims Adjuster (ACA)
  • Certified DRP Appraiser & Estimator Certification
  • SHRM Certified Professional (SHRM-CP)
  • Salesforce
  • Master Claims Professional (MCP)
  • Registered Professional Liability Underwriter (RPLU)
  • Certified Public Accountant (CPA)
  • ISO 9001 Lead Auditor Certification
  • Certified Property & Casualty Adjuster (CPCA)
  • Six Sigma Green Belt Certification

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