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Skills

  • Applicant engagement
  • Relationship development
  • Long-Term Disability (LTD) Claims Management
  • Disability Appeals Processing
  • Case management
  • Deadline management
  • Metric equipment
  • Customer satisfaction improvement
  • Team collaboration
  • Process improvement

Work Experiences

  • Clarified policy terms and conditions.
  • Assisted legal teams by providing accurate, detailed case summaries that supported successful litigation on over 10 claims disputes.
  • Collaborated with medical professionals.
  • Collaborated with medical professionals to verify the validity of disability claims, adhering to program rules and regulations.
  • Collaborated with physicians, vocational experts, and attorneys.
  • Reviewed applications for various aid programs and determined which individuals met the eligibility requirements.
  • Avoided $15 in potential penalties.
  • Conducted interviews with applicants and explained the scope of various benefits that were available.
  • Provided career-related consulting services to over 13 people and communicated with them to determine their needs and goals.
  • Achieved results in the first metric.

Summaries

  • Collaborated with multi-disciplinary teams.
  • Accomplished through compelling presentations to senior management.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved 54% increase in efficiency.
  • Within Miscellaneous, senior Disability Claims Specialist and outstanding performer in risk assessment and budget management.
  • Employers and community organizations are contacted to identify job opportunities for clients.
  • Achieved 65% improvement in accuracy.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved a 31% improvement in claimant satisfaction.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.

Accomplishments

  • Created and maintained comprehensive legal documentation based on federal and state guidelines, which led to process.
  • Developed a claimant feedback program, resulting in a 38% increase in claimants' overall satisfaction scores.
  • Developed new claims processing protocol reducing average case resolution time by metric, resulting in a 74% increase in operational efficiency.
  • Streamlined the intake process, reducing intake time by 28% and improving the accuracy of claimant information.
  • Orchestrated a claims audit initiative, identifying 4 incorrectly processed claims and recovering 12 in misallocated funds.
  • Assessed potential litigation risks in denied cases, resulting in a 21% mitigation of long-term financial liabilities.
  • Developed a compliance training program for new claims reviewers, leading to a 60% improvement in compliance accuracy within category.
  • Handled sensitive claimant medical information in compliance with HIPAA regulations, avoiding any legal complications or breaches.
  • Standardized disability claims review processes across 6 states, reducing administrative inconsistencies and improving compliance metrics.
  • Investigated complex cases involving overlapping jurisdiction and insurance programs, reducing processing delays by initiative.

Affiliations

  • National Association of Benefits and Disability Professionals (NABDP)
  • Lions Club
  • Member of the Financial Services Institute Disability Benefits Focus Group
  • Alumni of initiative, with a focus on Healthcare Administration
  • Society of Human Resource Management (SHRM), Professional Member, Active Since 2021
  • Certified Disability Management Specialist (CDMS) Lean
  • International Council of Nurses
  • Freemason
  • Project Management Institute
  • Healthcare Compliance Association (HCCA) Membership

Certifications

  • Social Security Disability Insurance (SSDI) Claims Examiner Certification
  • Certified Claims Specialist (CCS)
  • Google Certified Professional Cloud Architect
  • Project Management Professional (PMP)
  • Medical Billing and Coding Certification with a focus on long-term care claims
  • Certified Professional in Healthcare Quality (CPHQ)
  • Disability Management Employer Coalition (DMEC) Certification
  • Certified Public Accountant
  • Certified Business Analysis Professional (CBAP)
  • Disability Insurance Specialist Certification (DIC)

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