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Skills

  • Process improvement methodologies
  • Process improvement
  • Organization
  • Compliance with regional insurance regulations
  • Project organization
  • Fraud detection and prevention strategies
  • Automation of claims processing workflows
  • Account management
  • Catastrophe claims management
  • KPI tracking and performance measurement

Work Experiences

  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Assisted in the implementation of a claims management system.
  • Aligned settlements with policy terms.
  • Assessed damage reports from adjusters.
  • Created customized communications templates for claimants which boosted engagement and reduced follow-up requests by 54%.
  • Coordinated multiple claim-handling teams to process high-volumes during major catastrophe events, managing a surge of 2 claims.
  • Coordinated with legal, medical, and technical experts.
  • Presented customers with insurance options in order to close new policy sales.
  • Captured critical claim data.
  • Achieved compliance improvement over 2018.

Summaries

  • Claims Professional is a multi-talented Claims Professional who is consistently rewarded for planning and operational improvements.
  • Achieved recovery in several months.
  • Accomplished in training junior adjusters, improving department productivity by 62% through systematic process and knowledge enhancements.
  • Achieved a 71% reduction in processing time.
  • Accomplished Claims Professional with a proven ability to resolve customer disputes quickly, improving satisfaction scores by 28% in 2016.
  • Experienced category Insurance Specialist with a track record of managing large caseloads in high-pressure situations.
  • Consistently maintained settlement values aligned with case merits.
  • Claims Professional with 12 years of experience, dedicated to providing personalized, courteous service.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the metric business.
  • Achieved a settlement value ratio of 60%.

Accomplishments

  • Collaborated with team of 6 in the development of process.
  • Engineered claims tracking reports that improved insights into claims performance metrics, boosting team accountability.
  • Collaborated closely with legal teams to minimize litigation risks during high-exposure claims, contributing to a 72% reduction in legal expenses.
  • Implemented an automated claims management system that reduced manual data entry by 46%, improving efficiency across departments.
  • Played a key role in an internal audit which uncovered 13 potential compliance issues and led to immediate corrective actions.
  • Coordinated the processing of 7 claims during peak catastrophe season, reducing turnaround time by 19%.
  • Redesigned customer claims portal system, resulting in a 36%-point increase in online filing rates.
  • Designed and executed a continuous process improvement initiative, resulting in a 61% boost in operational claims efficiency.
  • Resolved product issue through consumer testing.
  • Contributed to a procedure policy overhaul that resolved historical claims issues, reducing repeat claims cases by 68%.

Affiliations

  • Rotary International
  • American Marketing Association
  • Claims and Litigation Management Alliance (CLM)
  • Project Management Institute
  • International Association of Special Investigation Units (IASIU)
  • Risk and Insurance Management Society (RIMS)
  • Property Casualty Insurers Association of America (PCIAA)
  • Claims Management Association
  • International Association of Claim Professionals (IACP)
  • Insurance Institute of America (IIA)

Certifications

  • CompTIA Network+
  • Claims and Insurance Fraud Specialist (CIFS)
  • Associate in Claims (AIC) from The Institutes
  • Special Investigator Certification (SIC)
  • Chartered Insurance Professional (CIP)
  • CompTIA A+ Technician
  • Microsoft Certified Systems Engineer (MCSE)
  • Cisco Certified Network Associate (CCNA)
  • Advanced Certified Adjuster Designation
  • Auto Damage Appraiser License

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