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Skills

  • Process implementation
  • Damage itemization
  • Product testing
  • Interpersonal and written communication
  • First Aid/CPR
  • Escalation management
  • Process automation
  • Data Management
  • Supervision
  • Public speaking

Work Experiences

  • Examined departmental documents to determine how they should be distributed and filed.
  • Accurately processed claims.
  • Achieved results within 2 months.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Was able to effectively respond to customer requests via phone and email, as well as answer questions and inquiries.
  • Applied data mining techniques.
  • Assessed high-volume property damage claims.
  • Accelerated onboarding success within 7 weeks.
  • Achieved closure by 2023.
  • Oversaw the delivery of program project by system team, which resulted in metric.

Summaries

  • Conducted careful review and detailed documentation.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Collaborative professional with a strong focus on cross-department cooperation, driving quicker resolution of complex claims worth over $13.
  • Clear understanding of process improvement and workflow optimization as well as vendor management training.
  • Claims Service Specialist with exceptional customer service, time management, and service coordination skills.
  • Achieved a 27% improvement in key claim metrics.
  • Consistently maintained compliance.
  • Certified in claims management with demonstrated expertise in leading teams through regulatory audits while ensuring adherence to industry standards.
  • Dynamic communicator who consistently outperforms company goals and expectations.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.

Accomplishments

  • Mentored junior claims agents and provided ongoing training, leading to an overall team performance increase by 32%.
  • Created and distributed monthly performance reports for senior management, tracking improvements in claims processing efficiency by 53%.
  • Reviewed and approved high-value claims, ensuring accuracy and expediency while saving the company approximately $4 annually.
  • Enhanced the customer claims journey by developing a more efficient service model, leading to a net promoter score (NPS) increase of 23%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Led audit preparedness for the claims department, ensuring 100% compliance with system and achieving zero audit findings.
  • Executed detailed claim audits, discovering errors and reducing processing time by 35%, ultimately leading to fewer customer disputes.
  • Utilized initiative to efficiently manage high-volume claims, reducing average claim handling time by 40% minutes.
  • Resolved product issue through consumer testing.
  • Implemented a fast-track appraisal system for low-value claims, decreasing overall examination time by 55%.

Affiliations

  • National Underwriter Claims Resource Center
  • Healthcare Financial Management Association (HFMA)
  • Society of Women Engineers
  • National Association of Insurance Commissioners (NAIC)
  • American Association of Healthcare Administrative Management (AAHAM)
  • American Society of Safety Professionals
  • Property Casualty Insurers Association of America (PCIAA)
  • National Claims Adjusters Association (NCAA)
  • Association of Certified Fraud Examiners (ACFE)
  • Claims and Litigation Management Alliance (CLM)

Certifications

  • ServSafe
  • Advance Fraud Examiner Certification (AFE) – Association of Certified Fraud Examiners (ACFE)
  • SHRM Certified Professional (SHRM-CP)
  • Certified Insurance Data Analyst (CIDA) – Data Science Certification Body
  • Advanced Insurance Law Certificate – metric
  • First Aid/CPR Certified
  • Apple Certified Associate (ACA)
  • Licensed Independent Adjuster (IA) – Columbus Department of Insurance
  • CompTIA Security+
  • Insurance Billing and Coding Specialist (IBCS) Certification – framework

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