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Skills

  • Project organization
  • Cross-Team Project Leadership
  • Budgets
  • Customer service
  • Cross-functional collaboration
  • Vendor relationship management
  • Claims triage optimization
  • Supervision
  • Automated fraud detection
  • Claims-cycle time reduction

Work Experiences

  • Analyzed quarterly claims trends and presented actionable insights to the leadership team, contributing to a 29% increase in profitability.
  • Built effective partnerships with external experts.
  • Analyzed quarterly claims trends.
  • Collaborated with cross-functional teams to implement a new claims processing system, resulting in a 65% reduction in manual entry errors.
  • Coached junior claims handlers.
  • Contributed to a 32% increase in profitability.
  • Achieved 15% performance improvement in file review accuracy.
  • Developed a rapid-response protocol.
  • Boosted team productivity by 26%.
  • Coordinated with legal teams to finalize settlements, reducing external legal costs by $16 annually.

Summaries

  • Customer-oriented manager specialized in claims review processes.
  • Consistently reduced claim resolution times.
  • Category professional with 10 years of experience evaluating coverage and supervising claims review.
  • Achieved profitability increases of 65%.
  • Accomplished in revamping internal claims procedures, reducing legal exposure by 22% through ensuring compliance with evolving regulatory requirements.
  • Achieved substantial claims savings.
  • Accomplished in building cross-functional relationships to support seamless claims integration with other departments, reducing manual entry errors by 79%.
  • Consistently exceeded KPI benchmarks.
  • Customer-oriented manager specialized in claims review processes, with consistent success in raising service quality and policyholder satisfaction by 65% through structured appeals systems.
  • Accomplished Claims Unit Manager with a history of driving 73% reduction in claim processing errors through the introduction of advanced automated systems and procedural updates.

Accomplishments

  • Enhanced customer communication strategies, leading to improved claim closure rates by 75% while increasing customer satisfaction.
  • Assumed leadership on high-priority claims, resolving disputes and reducing customer escalations by 33%.
  • Developed comprehensive guidelines to align with regulatory changes, minimizing compliance violations by 81%.
  • Spearheaded efforts to optimize claims investigation procedures, reducing open claim counts by 2 over a 11-month timeframe.
  • Increased claim approval speed by 37% through team collaboration and workload optimization strategies.
  • Documented and resolved system which led to program.
  • Led a cross-functional task force aimed at reducing claim cycle times, achieving a 5-day improvement within 2016 months.
  • Collaborated with team of 13 in the development of system.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Led a claims team of 17 adjusters, successfully reducing claim handling time by 16%.

Affiliations

  • American Risk and Insurance Association (ARIA)
  • Jaycees
  • National Association of Insurance Commissioners (NAIC)
  • National Council on Compensation Insurance (NCCI) Committee Member
  • Toastmasters
  • National Council on Compensation Insurance (NCCI)
  • Rotary International
  • International Association of Administrative Professionals
  • Society of Actuaries (SOA) Claims Management Forum
  • American Society of Safety Professionals

Certifications

  • Certified Claims Professional (CCP) – Cedar Works, 2021
  • Six Sigma Green Belt Certification - Northwind - 2022
  • Certified Insurance Anti-Fraud Professional (CIAFP) - Summit Group
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Public Accountant (CPA)
  • Dispute Resolution and Mediation Certification - program
  • Chartered Property Casualty Underwriter (CPCU) – Brightline, 2023
  • Business Process Management Certification - category
  • Insurance Institute of America (IIA) Designation - 2015
  • CompTIA Security+

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