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Skills

Case management software proficiency (QuickBooks)
Accuracy in claims reporting 52%
Cross-functional team coordination
Problem resolution
Process improvement
Compliance with state and federal disability laws
Communications
Project organization
Database management
Organization

Work Experiences

Awarded in 2017.
Workday was delivered to customer locations by me.
Achieved a 17% improvement in claimant retention.
Achieved results across a two years-month span.
Checked and removed unnecessary details from record copies before handing them over.
Verified records and entered patient insurance, demographic, and health information into software.
Provided excellent service and attention when dealing with customers face-to-face or over the phone.
All requests for medical records were entered into spreadsheets.
Analyzed large datasets to identify emerging trends in claim denials, helping to mitigate potential process bottlenecks.
Championed a team culture of empathy.

Summaries

Disability Claims Analyst is a hardworking and dependable Disability Claims Analyst who excels at stakeholder engagement and quality assurance.
System, program, and system are all available.
Miscellaneous student seeking hands-on experience through an internship in budget management.
Disability Claims Analyst and team leader with 5 years of experience in system settings.
Looking forward to taking on a new challenge with a successful team.
Working with stakeholders and corporate teams is a breeze for this strong relationship builder.
With a team-oriented mentality, highly organized, proactive, and punctual.
Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
Achieved 40% accuracy.
Achieved results within the past year.

Accomplishments

Reviewed and analyzed 10 disability claims per week, determining eligibility based on medical evidence and policy guidelines.
Worked with legal and regulatory teams to interpret new disability laws, ensuring our processes remained compliant and up to date.
Achieved 70% adherence to internal and external audit requirements, minimizing compliance risks and penalties for 2020.
Monitored industry trends and regulatory changes, recommending policy amendments that optimized claim processing for accuracy and compliance in 2023.
Specialized in reviewing complex claims involving chronic conditions, coordinating with category to ensure accurate eligibility determinations.
Oversaw quality assurance programs related to claims evaluations, ensuring that 4 claims were audited for compliance each quarter.
Collaborated with national and regional teams to streamline complex claims, resolving 6 cases from multiple jurisdictions with minimal escalations.
Independently evaluated and closed 9 claims per quarter, consistently exceeding department benchmarks for accuracy and claimant satisfaction.
Trained and mentored junior analysts on claims assessment and policy interpretation, improving team accuracy and reducing audit findings by 68%.
Developed detailed and well-supported rationales for claim decisions, resulting in 56% decrease in appeals and reconsideration requests.

Affiliations

Participant, Workers' Compensation Institute Conference
Member – American Academy of Professional Coders (AAPC)
Enrolled in Certified Case Manager (CCM) Program
Affiliate, International Foundation of Employee Benefit Plans (IFEBP)
Member, International Claim Association (ICA)
Certified Disability Management Specialist (CDMS) through the Commission for Case Manager Certification
Active Member, Association for Financial Professionals (AFP)
Member, Disability Management Employer Coalition (DMEC)
Member, Case Management Society of America (CMSA)
Board Member, category Disability Resources Organization

Certifications

Salesforce
SHRM Senior Certified Professional (SHRM-SCP)
Apple Certified Associate (ACA)
Certified Public Manager (CPM)
ServSafe
Certified Business Analysis Professional (CBAP)
Certified HIPAA Privacy Associate (CHPA)
Certified Workers' Compensation Integrity Professional (WICP)
Certified in Risk and Information Systems Control (CRISC)
Disability Claims Law Specialist (DCLS)

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Disability Claims Analyst Resume Builder

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