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Skills

  • Error rate reduction in claims processing
  • Cross-functional collaboration with legal teams
  • Regulatory compliance
  • Litigation avoidance strategies
  • Emergency Response
  • Problem resolution
  • Client relationship management
  • Organization
  • Claims resolution rate improvement
  • MS Office

Work Experiences

  • Addressed gaps in claims workflows.
  • Conducted detailed investigations.
  • Achieved results across 18 months.
  • Adjusted company claims handling policies.
  • Oversaw the delivery of program project by procedure team, which resulted in metric.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Achieved a 78% satisfaction rate post-settlement.
  • Authored a disaster recovery protocol.
  • Transported Adobe Creative Suite to the past year customer locations.
  • Acted as the primary point of contact for insureds during complex multi-party claims, achieving a 80% satisfaction rate post-settlement.

Summaries

  • Conducted proactive claims assessments.
  • Conducted in-house investigations.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the method business.
  • Achieved savings of $18 for the company.
  • Claims Management Specialist with 9 years of successful performance reporting and project management experience.
  • Achieved process improvements.
  • Client-relationship driven, having increased customer retention by 16% through effective claims resolution and personalized support.
  • Achieved consistency in claims processing.
  • Completed within a 6 months period.
  • Achieved reductions in company liability.

Accomplishments

  • Created a claims reporting dashboard in ServiceNow, providing real-time data to executives and reducing reporting time by 63%.
  • Resolved product issue through consumer testing.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Acted as the key liaison in resolving complex, high-stake claims, bringing resolution to 15 cases valued at over $60,000.
  • Oversaw claims audits within the department, ensuring 54% compliance with regional and federal regulations.
  • Collaborated with team of 13 in the development of standard.
  • Reduced insurance premiums by collaborating with underwriting to incorporate data-driven risk analysis into pricing models, benefiting 9 clients.
  • Led initiatives to integrate Workday into everyday claims processing, which decreased claim cycle time by 7 days.
  • Documented and resolved metric which led to category.
  • Facilitated team workshops on mediation and conflict resolution techniques, cutting client disputes over settled claims by 54%.

Affiliations

  • Volunteer Trainer for the National Alliance for Insurance Education & Research – Led education on handling contentious claims and mitigating risk.
  • Society of Women Engineers
  • Active member of the Society of Insurance Trainers & Educators (SITE) – Delivered presentations on efficient claims processing and root cause analysis.
  • Attendee, Workers’ Compensation Institute (WCI) annual conference – Attended workshops on improving high-volume claims processing.
  • Certificate in Advanced Claims Studies from the Insurance Institute of America (IIA) – Specialized in complex claims and enhanced process efficiency.
  • National Council on Compensation Insurance (NCCI) Affiliate – Regularly attended workshops on compensation trends and managing disputed claims.
  • Affiliate of the ClaimsXchange network – Contributed thought leadership on customer expectation management in high-volume claims environments.
  • Member of the Claims and Litigation Management Alliance (CLM) – Engaged in forums on reducing external legal expenses through settlement strategies.
  • Annual membership with the Federation of Regulatory Counsel (FORC) – Engaged legal experts on regulatory compliance and its effect on claims handling.
  • Annual attendee at the Public Risk Management Association (PRIMA) – Learned best practices in liability risk and large-scale claims settlements.

Certifications

  • Certificate in Casualty Adjusting
  • Claims Resource Specialist Certification (CRSC)
  • Certified Public Accountant
  • Certified Litigation Management Professional (CLMP)
  • CompTIA Security+
  • Apple Certified Associate (ACA)
  • Google Certified Professional Cloud Architect
  • Fraud Prevention for Insurance Professionals Certification
  • Chartered Property Casualty Underwriter (CPCU)
  • First Aid/CPR Certified

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