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Skills

  • Claims processing management
  • Detail-oriented document review
  • Security systems
  • Operational improvement
  • Customer complaint resolution
  • MS Office
  • Customer-first approach to communications
  • Business operations
  • Customer Satisfaction Monitoring
  • Process improvement

Work Experiences

  • Achieved this in 2016.
  • Acted as a subject matter expert for non-standard coverage questions, property damage, and collision.
  • Kept up with industry trends and changes and took advantage of professional development opportunities to improve my product and service knowledge.
  • Was in charge of all tasks delegated to me, including strategic planning and process improvement.
  • Finished category of project, which resulted in standard.
  • Learned quality assurance and vendor management to help with office needs.
  • Collaborated directly with a legal team to ensure proper handling of system, decreasing litigation rates by 63% over 7 months.
  • Achieved this over a 2023-year period.
  • Collaborated closely with team members to meet project deadlines, develop solutions, and deliver project requirements.
  • Clarified confusing technical terms.

Summaries

  • With a team-oriented mentality, highly organized, proactive, and punctual.
  • 14 years of experience in processing claims.
  • Comprehensive understanding of insurance forms, procedures, and policies.
  • Motivating leader who has built and managed metric teams in the past.
  • Student pursuing a Miscellaneous degree who is eager to contribute developed knowledge in the role of Claims Support Assistant.
  • Knowledge of ServiceNow in depth, as well as project management and budget management abilities.
  • Method, procedure, and method are all available.
  • Analytical Claims Support Assistant with strong data-gathering, report-writing, and data-compilation abilities.
  • Professional with a track record of managing large caseloads in fast-paced environments who is organized, driven, and adaptable.
  • Achieved 17% improvement in claims process efficiency.

Accomplishments

  • Monitored multiple claims processing queues, identifying bottlenecks and improving processing speed by 80% hours.
  • Monitored daily claims submissions for inconsistencies, decreasing fraudulent claims by 53% over 8 months.
  • Optimized the claims filing system, reducing lost or misplaced claim cases by 56% and improving historical data retrieval times.
  • Collaborated on the rollout of a new electronic claims system, improving overall process efficiency and cutting manual work by 85%.
  • Provided accurate claims entry support during a time-sensitive period, helping the team meet a critical deadline which resulted in 36% timely payouts.
  • Enhanced accuracy in claims submission by implementing a dual-review process, reducing resubmissions by 45% per quarter.
  • Provided dedicated claims support, ensuring 53% compliance with regulatory requirements and decreasing audit issues.
  • Coordinated with various departments to ensure all claims were processed within specific SLAs, achieving timely closure on 54% of claims.
  • Assisted in creating a standardized rejection code system that minimized confusion and improved claim approval rates by 43% in 2021.
  • Performed detailed review of over 5 claim files monthly, lowering rejections due to incomplete documentation by 55%.

Affiliations

  • Member of the National Association of Independent Insurance Adjusters (NAIIA), actively participating in educational webinars and annual conferences.
  • Professional member of the International Claim Association (ICA) to stay informed of ongoing industry regulations and legislative changes.
  • Contributor to internal working groups at the National Association of Mutual Insurance Companies (NAMIC), improving cross-team cooperation within claims divisions.
  • Active participant in webinars hosted by the Society of Insurance Research (SIR), sharing insights on real-time reporting and claims data analytics.
  • Engagement in cross-training workshops through the International Association of Insurance Professionals (IAIP), helping streamline cross-functional claims procedures.
  • Member of the Association of Certified Fraud Examiners (ACFE), gaining additional skills in identifying and handling fraudulent claims.
  • Active member of the Risk and Insurance Management Society (RIMS), participating in discussions on mitigating claim-related risks.
  • Regular attendee of the Casualty Actuarial Society seminars to improve data management in casualty claims handling processes.
  • Completed CPA from The Institutes, reinforcing skills in claims operations and improving process efficiency by 29%.
  • Member of the Society of Insurance Trainers and Educators (SITE), frequently enhancing skills in system training and claims process education.

Certifications

  • Licensed Insurance Customer Service Representative (LICSR)
  • Chartered Property Casualty Underwriter (CPCU)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Public Accountant (CPA)
  • Applied Insurance Analytics Certification Beacon Labs
  • Certified Compliance and Ethics Professional (CCEP)
  • Certified Risk Adjustment Coder (CRC)
  • Certified Risk Management Professional (CRMP)
  • Certified Fraud Examiner (CFE)
  • Certified Business Intelligence Professional (CBIP)

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