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Skills

  • First Aid/CPR
  • Process automation and efficiency improvements
  • Insurance policy interpretation
  • Analytical Thinking and Problem Solving
  • Closed claims auditing
  • Complex injury and damages claim handling
  • Litigation avoidance through mediation
  • Claims exposure analysis with legal teams
  • Project management for claims investigations
  • Claims turnaround time optimization

Work Experiences

  • Actively contributed to process improvements, reducing claim processing times by 41% while maintaining accuracy.
  • Achieved a 22% customer satisfaction score.
  • Built strong customer relationships.
  • Determined liability as outlined in the coverage and assessed documentation from police and healthcare providers to understand the damages incurred.
  • Championed cross-departmental initiatives to enhance the claims intake process, improving first-contact resolution rates by 63%.
  • Achieved the highest monthly performance score in 2024 for claims processing, exceeding departmental KPIs by over 40%.
  • Adhered to stringent policies.
  • Examined claim forms and other records to determine insurance coverage.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Actively contributed to process improvements.

Summaries

  • Strengths in risk assessment and process improvement backed up by Miscellaneous training.
  • Collaborative team player.
  • Achieved 55% favorable feedback in customer surveys.
  • Clear understanding of budget management and workflow optimization as well as client relations training.
  • Within Miscellaneous, senior Claims Generalist and outstanding performer in budget management and strategic planning.
  • Adept at working with underwriting departments.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Achieved a 58% improvement in first-contact resolution.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Applied expert negotiation skills.

Accomplishments

  • Utilized empathy and active listening techniques in customer interactions to de-escalate 16 high-tension disputes.
  • Served as a key liaison between the claims department and external stakeholders to improve communication flow and expedite case processing.
  • Facilitated negotiations between claimants and insurance companies to settle claims expeditiously while maintaining a 82% settlement success rate.
  • Introduced a mentorship program within the claims department, reducing new hire ramp-up time by 27% months.
  • Documented and resolved method which led to system.
  • Resolved complex claims disputes by negotiating settlements, achieving a 28% customer satisfaction score in post-resolution surveys.
  • Led claims review sessions with cross-functional teams, resulting in the identification and mitigation of 6 potential fraudulent cases.
  • Achieved PMP to enhance understanding of claims management protocols and further advance operational efficiency.
  • Proactively identified trends in customer complaints and initiated corrective actions, leading to a 25% reduction in escalations.
  • Collaborated with legal counsel and underwriting teams to minimize claim exposure, reducing liability costs by $15 annually.

Affiliations

  • Professional Liability Underwriting Society (PLUS)
  • Insurance Institute of America (IIA)
  • International Association of Administrative Professionals
  • International Council of Nurses
  • Association of Information Technology Professionals
  • American Property Casualty Insurance Association (APCIA)
  • National Alliance for Insurance Education and Research (Certified Insurance Counselor)
  • Claims Litigation Management Institute
  • Rotary International
  • Certified Professional Insurance Woman (CPIW) - National Association of Insurance Women

Certifications

  • Legal Principles Claims Specialist (LPCS)
  • Certified Public Accountant
  • General Insurance (INS) Certification
  • CompTIA A+ Technician
  • Apple Certified Associate (ACA)
  • Life and Health Claims Certification
  • Certified Professional in Disability Management (CPDM)
  • Certified Professional Insurance Investigator (CPII)
  • Certified Accident Claims Adjuster (CACA)
  • Associate in Risk Management (ARM)

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