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Skills

  • Business operations
  • Supervision
  • Benefits review
  • Cross-functional collaboration
  • Organization
  • Relationship development
  • Problem resolution
  • Time management
  • Customer service
  • Team management

Work Experiences

  • Transported Adobe Creative Suite to one year customer locations.
  • Achieved a 64% reduction in claims reserves.
  • Applied frameworks across 11 cases.
  • Solved process issues, improved operations, and provided excellent customer service.
  • Collaborated with underwriting, legal, and finance departments.
  • Collaborated with multiple departments to streamline workflows, reducing claim processing time by 19% and enhancing overall efficiency.
  • Achieved a 69% improvement in claims resolution time.
  • Coordinated 17 team members.
  • Collaborated with the technology team.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.

Summaries

  • Achieved a 31% positive resolution rate on disputed coverage cases.
  • Achieved a 26% reduction in claims cycle time.
  • Achieved 33% cost savings annually.
  • Achieved results within 6 months.
  • To deliver information to policyholders, makes use of well-developed communication skills.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Trains and mentors employees to ensure that policies, procedures, and applicable laws are followed.
  • Adept Claims Director with extensive experience.
  • Claims Director is a multi-talented Claims Director who is consistently rewarded for planning and operational improvements.
  • Accomplished in legal claims management.

Accomplishments

  • Led claims management team to achieve 74% faster client resolution timeframes by refining the claims adjudication process.
  • Analyzed historical claims data and developed a capacity planning model that improved resource allocation by 73%.
  • Reduced claims expenses by 18% through targeted negotiations, vendor management, and reviewing fraudulent claims.
  • 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.
  • Coached claims examiners and analysts, resulting in a 55% increase in first-pass resolution rates within 2015.
  • Documented and resolved standard which led to procedure.
  • Leveraged predictive analytics tools which contributed to identifying fraudulent activity early and reduced processing cost by $4.
  • Designed and implemented a claims strategy that reduced overall settlement time by 43%, directly supporting the organization’s profitability goals.
  • Championed a customer feedback program that improved service recovery times, driving overall satisfaction scores up by 56%.
  • Directed the overhaul of claims processing procedures which resulted in a 40% decrease in manual intervention and errors.

Affiliations

  • Academy of Insurance Professionals (AIP)
  • Society of Women Engineers
  • Society for Healthcare Risk Management (SHRM)
  • Property Casualty Insurers Association of America (PCI)
  • Lions Club
  • Risk and Insurance Management Society (RIMS)
  • American Society of Safety Professionals
  • International Council of Nurses
  • Association of Claims Professionals (ACP)
  • Freemason

Certifications

  • Master Claims Professional (MCP)
  • Registered Professional Liability Underwriter (RPLU)
  • Google Certified Professional Cloud Architect
  • Cisco Certified Network Associate (CCNA)
  • Six Sigma Green Belt Certification
  • Insurance Regulatory Compliance Certification
  • First Aid/CPR Certified
  • Certified Fraud Examiner (CFE)
  • Insurance Data Analytics & Decision Making Certification – process
  • CompTIA Security+

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