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Skills

  • Time management
  • Claims Management Software Implementation
  • Claims Auditing
  • Insurance policy knowledge
  • Coaching and leadership
  • Account management
  • Data entry accuracy
  • Operational improvement
  • Negotiation skills
  • Communications

Work Experiences

  • Collaborated with underwriters and adjusters to expedite the review of Jira policy claims, reducing average turnaround time by 69%.
  • Brought unresolved issues to the attention of senior management, improving claim resolution time by 63%.
  • Assisted with the roll-out of online claim submission features, resulting in a 18% rise in self-submitted claims and reduced administrative workload.
  • Kept patient finances, records, and health statuses confidential.
  • Transported HubSpot to three years customer locations.
  • Collaborated with multi-disciplinary teams.
  • Achieved a 53% improvement in departmental performance.
  • Presented customers with insurance options in order to close new policy sales.
  • Analyzed claim volumes and adjusted resource allocation, improving team performance by 77% during high-demand periods.
  • Reviewed open requests and redirected workloads to ensure that projects were completed on time.

Summaries

  • Achieved a 17% increase in satisfaction.
  • Addresses complex claims issues.
  • Claims Service Assistant with 12 years of experience, dedicated to providing personalized, courteous service.
  • Adept in resolving complex claims issues.
  • Analytical and detail-oriented Claims Service Assistant adept at conducting regular audits, ensuring compliance, and minimizing pending claims to meet industry benchmarks.
  • Achieved efficiency through teamwork and status tracking.
  • Adaptable Claims Service Assistant.
  • Clear understanding of stakeholder engagement and team leadership as well as stakeholder engagement training.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Bringing 8 years of insurance experience to the table.

Accomplishments

  • Created a triage system for incoming claims that improved the intake process and shortened response times by 65%.
  • Monitored claim follow-up timelines and escalated urgent cases immediately, resulting in a 71% reduction in overdue claim resolution rates.
  • Collectively identified system inefficiencies with team, leading to a claims software upgrade that reduced manual entry by 54%.
  • Created and distributed claim outcome letters using standardized templates, streamlining communications and cutting down average response times by 5 days.
  • Contributed to the documentation of claims processing best practices in a shared company knowledge base, decreasing training times for new team members by 4 weeks.
  • Resolved 13 escalated claim issues, contributing to a 40% retention boost in policyholder renewals within 18 months.
  • Provided specialized support for catastrophic claims, ensuring expedited handling resulted in a 46% reduction in resolution time.
  • Assisted the fraud investigation team by flagging 4 high-risk claims, contributing to a 61% decrease in fraudulent payouts.
  • Trained 12 new hires on claims processing protocols in 2019, resulting in improved team performance and faster claim handling.
  • Resolved product issue through consumer testing.

Affiliations

  • American Insurance Association (AIA)
  • Lions Club
  • Accredited Advisor in Insurance (AAI)
  • Toastmasters
  • Association for Computing Machinery
  • Freemason
  • Project Management Institute
  • Rotary International
  • National Association of Insurance Commissioners (NAIC)
  • Professional Liability Underwriting Society (PLUS)

Certifications

  • ServSafe
  • Fraud Prevention and Detection (FPD) Certification
  • Total Quality Claims Consultant (TQCC)
  • Apple Certified Associate (ACA)
  • Associate Customer Service (ACS) Certification
  • CompTIA Network+
  • SHRM Senior Certified Professional (SHRM-SCP)
  • ISO Claims Search Certification
  • Certified Healthcare Insurance Specialist (CHIS)
  • Loss Control Management Certification

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