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Skills

  • Process equipment
  • Client relationship management
  • Cost-saving initiatives implementation
  • Budgets
  • Adherence to claims procedures and guidelines
  • Claims data analysis
  • Cross-functional collaboration
  • Team management
  • Time management
  • Advanced Excel or data reporting tools Jira

Work Experiences

  • Assessed large-scale disaster claims, ensuring a timely and compassionate response to affected policyholders during framework.
  • Cross-referenced claims against fraud indicators.
  • Developed and launched a claims status portal which allowed customers to track their claims in real-time, reducing call center volume by 68%.
  • Transported Jira to one year customer locations.
  • Cut down claims resolution time by 10 business days.
  • Solved framework issues, improved operations, and provided excellent customer service.
  • Saved $2 by putting in place cost-cutting measures that addressed long-standing issues.
  • Achieved a 61% improvement in client satisfaction surveys.
  • Assessed high-risk claims.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.

Summaries

  • Coordinated with multiple departments.
  • Achieved real-time claim updates.
  • Committed to creating positive claimant experiences.
  • Adept at handling high-volume claims processing, outperforming team productivity goals by 45% while maintaining high-quality compliance with industry standards.
  • Collaborative professional adept at coordinating with external vendors.
  • Conducted further review of high-risk activities.
  • Boosted claimant satisfaction by 40%.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the procedure business.
  • Collaborative professional adept at coordinating with external vendors and cross-functional teams, reducing claims resolution times by 12 days.
  • Consistently maintained strict adherence to company policies.

Accomplishments

  • Collaborated with IT and finance departments to improve claims reconciliation processes, resulting in 72% faster resolution times.
  • Implemented a new cloud-based claims intake system, reducing human errors by 65% and increasing processing speed.
  • Managed escalated claims for 11 states, ensuring compliance with regional regulations and achieving 39% in resolution accuracy.
  • Developed and monitored performance dashboards using SAP, providing real-time updates on critical claim metrics.
  • Reduced claim processing times by 8 days through the implementation of a more efficient intake procedure, minimizing backlogs.
  • Co-authored new policies for claim escalations, standardizing responses and enhancing resolution rates by 68% in complex scenarios.
  • Implemented a claim review process using Jira, resulting in a 62% improvement in identification of inconsistencies.
  • Managed a portfolio of over 7 client cases, achieving a 85% claims accuracy rate and minimal client disputes.
  • Documented and resolved framework which led to program.
  • Successfully optimized claims resource allocation, leading to costs savings of 17% annually over the past year.

Affiliations

  • American Society of Safety Professionals
  • Lions Club
  • Association of Claims Professionals (ACP)
  • National Association of Social Workers
  • Association of Information Technology Professionals
  • International Federation of Health Plans (IFHP)
  • Institute of Financial Operations (IFO)
  • International Association of Administrative Professionals
  • Society of Insurance Research (SIR)
  • International Association of Special Investigation Units (IASIU)

Certifications

  • CompTIA Security+
  • Project Management Professional (PMP)
  • Google Certified Professional Cloud Architect
  • Claims and Risk Assessment Certificate - Brightline
  • Insurance Data Analytics Certificate - method
  • Electronic Claims Management Certification - AHIMA
  • Certified Public Accountant (CPA)
  • Accredited Customer Service Representative (ACSR) - procedure
  • Property & Casualty Insurance License - initiative
  • Insurance Operations Specialist Certificate - system

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