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Skills

  • Great mathematical skills
  • Audit Readiness
  • Team management
  • Advanced Excel functions for data analysis
  • Claims automation software (e.g., Workday)
  • Customer Relationship Management (CRM)
  • Excellent verbal and written communication skills
  • Supervision
  • Adapting to regulatory changes
  • Exceptional phone etiquette

Work Experiences

  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Achieved claims closure within one year.
  • Was in charge of processing and recording new policies and claims.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Collaborated with vendors to expedite services.
  • Collaborated with underwriters and adjusters.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Authored training manuals for claims technicians and led quarterly seminars to address evolving industry standards.
  • Assisted in enhancing claims policy.
  • Communicated with clients, distributed mail, and scanned documents as part of my administrative duties.

Summaries

  • Achieved 19% improvements in data accuracy.
  • Dedicated Insurance Clerk with strong math and communication skills.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Accomplished Claims Technician with 10 years of experience in Tableau policies, consistently closing 76% of claims within three years.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Effective at managing phone calls, emails, letters, and in-person requests for assistance while adhering to process regulations and category department guidelines.
  • Achieved a 80% reduction in manual errors.
  • Achieved $7 in cost savings.
  • Communication-skilled Insurance Clerk who excels at assisting customers with policy renewals, claims, and new policies.
  • Achieved 44% improvement in data management quality.

Accomplishments

  • Monitored key compliance metrics and delivered consistent performance that ensured category was achieved and maintained, avoiding regulatory fines.
  • Collaborated with actuarial teams to evaluate and reduce high-risk claims by 73%, enhancing risk management performance.
  • Developed a reporting system to track team performance, resulting in a clear 31% improvement in KPIs such as claim resolution speed and overall accuracy.
  • Provided mentorship and training to a newly hired team of 8 claims technicians, boosting department efficiency by 69%.
  • Rolled out a new customer relationship management platform, improving claim interaction documentation and increasing customer retention by 30%.
  • Authored and updated training manuals for new hires, leading quarterly skill enhancement seminars to meet evolving claims handling standards.
  • Utilized bilingual fluency in Mandarin to manage and resolve a high volume of claims for initiative customers, improving customer satisfaction metrics.
  • Reduced outstanding claims volume from 6 to 18 within several months by optimizing communication workflows and customer follow-up procedures.
  • Led an initiative to automate claims documentation, reducing paperwork by 23% and enabling faster team response times.
  • Spearheaded the integration of a new claims management software, resulting in a 15% reduction in manual data entry time and increased processing efficiency.

Affiliations

  • Association of Information Technology Professionals
  • Association for Operations Management (APICS)
  • Association of Insurance Compliance Professionals (AICP)
  • Managed Care Risk Certification, 2015
  • Risk and Insurance Management Society (RIMS)
  • Project Management Institute (PMI)
  • Association for Supply Chain Management (APICS)
  • Healthcare Financial Management Association (HFMA)
  • International Council of Nurses
  • Chartered Property Casualty Underwriter (CPCU), method

Certifications

  • Salesforce
  • Accredited Adviser in Insurance (AAI)
  • Fraud Claim Law Specialist (FCLS)
  • Certified Case Manager (CCM)
  • Fellow, Life Management Institute (FLMI)
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Risk Manager (CRM)
  • CompTIA Security+
  • Certified Regulatory Compliance Manager (CRCM)
  • Apple Certified Associate (ACA)

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