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Skills

  • Customer service
  • Budgets
  • Business operations
  • Team management
  • MS Office
  • Data-driven process improvements
  • Relationship development
  • Process equipment
  • Problem resolution
  • Case Review Protocol Implementation

Work Experiences

  • Had an excellent attendance record and was always on time for work.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Collaborated with method customers to determine their needs and deliver procedure service.
  • Identified insurance coverage limitations with a thorough examination of claims documentation and related records.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Acted as the senior point of contact for complex cases.
  • Analyzed legislative changes.
  • Saved $18 by putting in place cost-cutting measures that addressed long-standing issues.
  • Collaborated with physicians and vocational experts to accurately assess a claimant's ability to perform work, contributing to better-informed decisions for over 18 cases annually.
  • Reviewed original investigation reports and documents to address secondary concerns.

Summaries

  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Within Miscellaneous, senior Disability Examiner and outstanding performer in team leadership and vendor management.
  • Collaborative Disability Examiner.
  • Adapted to policy updates.
  • Collaborated with medical and vocational experts.
  • Achieved a superior rate of claim approval accuracy.
  • Clear understanding of workflow optimization and vendor management as well as project management training.
  • Insurance adjuster who investigates and analyzes liability in the event of a personal, casualty, or property loss.
  • Costs were consistently reduced while profits were increased.
  • Collaborative Disability Examiner, recognized for contributing to a reduction in case resolution times by 3 days through successful teamwork with legal and medical experts.

Accomplishments

  • Successfully implemented an electronic claims review system that led to a 24% improvement in decision timeliness across the department.
  • Mentored a team of 15 disability examiners, helping them achieve case completion rate increases of 36% during the initial two years.
  • Enhanced claimant interview techniques, leading to better data collection and improving decision accuracy by 75% for all reviewed claims.
  • Spearheaded a project to integrate Tableau into daily case review processes, reducing manual errors and increasing productivity by 36%.
  • Developed comprehensive procedural manuals for disability determination, standardizing processes and reducing case review discrepancies by 78%.
  • Initiated a claimant communication strategy that improved transparency, leading to a 56% year-over-year decrease in escalations to appeals.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Performed high-quality review of medical and vocational evidence, consistently maintaining a 63% approval rating with external audit processes.
  • Resolved complex claimant issues involving medical and vocational disputes, improving public trust and decreasing rework cases by 18%.
  • Documented and resolved framework which led to program.

Affiliations

  • International Council of Nurses
  • American Marketing Association
  • Toastmasters
  • Social Security E-Business Partners Group (SSEP)
  • American Society of Safety Professionals
  • American Association of Healthcare Administrative Management (AAHAM)
  • Society for Human Resource Management (SHRM) – Disability Inclusion Committee
  • Disability Management International Council
  • SSA Disability Program Managers Association
  • American Bar Association (ABA) - Commission on Disability Rights

Certifications

  • CompTIA Security+
  • Certified Comprehensive Benefits Counselor (CBC) - Ironclad Systems
  • ServSafe
  • CompTIA A+ Technician
  • Certified Case Manager (CCM) – Commission for Case Manager Certification
  • Human Services Case Management Certification - Ironclad Systems
  • Social Security Administration Disability Program Specialist - Lakeside Partners
  • Social Security Disability Advocate (SSDA) - Summit Group
  • National Disability Navigator Credential - Brightline
  • First Aid/CPR Certified

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