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Skills

  • Escalated claims resolution
  • Customer satisfaction improvement
  • MS Office
  • Reporting abilities
  • Problem resolution
  • High-volume claims management
  • Business operations
  • Process improvement
  • Financial impact analysis
  • Communications

Work Experiences

  • Collaborated with claims analysts.
  • Collaborated closely with claims analysts to ensure prompt review of procedure claims, reducing outstanding claims from 14 to 13 in several months.
  • Assisted clients in navigating claim policies.
  • Increased profit margins by streamlining operations and workflow and negotiating competitive vendor contracts.
  • Analyzed method insurance claims.
  • Developed customer relationships in order to increase customer loyalty and retention.
  • Answered 17 phone calls per the past year to assist customers.
  • Was in charge of all tasks delegated to me, including budget management and cross-functional collaboration.
  • Achieved a claims resolution rate of 76%.
  • Collaborated with legal teams.

Summaries

  • Working with regulatory limits and framework department standards to handle requests via email, letter, phone calls, or in person is second nature to me.
  • Knowledge of Salesforce in depth, as well as performance reporting and strategic planning abilities.
  • Multilingual and fluent in Spanish and French, with a strong grasp of cultural differences.
  • Category, program, and category are all available.
  • Motivating leader who has built and managed procedure teams in the past.
  • Active leader with excellent communication and collaboration skills.
  • Accomplished Express Claims Associate.
  • Team leadership in initiative settings and strategic planning in client relations settings.
  • ITIL certified
  • Accomplished Express Claims Associate skilled in fraud prevention, claims auditing, and customer retention strategies, consistently identifying inefficiencies that save up to $5 annually in company payouts.

Accomplishments

  • Coordinated with external adjusters to expedite claims related to framework incidents, leading to faster settlement of 14 high-value claims.
  • Implemented a triage-based approach that reduced claims response time from standard to procedure, recognized with Innovation Award in 2018.
  • Trained a team of 4 new recruits, cutting training time by 46% and improving team processing speed by 58%.
  • Acted as a liaison between departments to facilitate quicker claims resolutions, reducing overall claim cycle times by 55%.
  • Utilized data-driven insights to prioritize claims, enhancing processing efficiency and reducing average handling time by 79%.
  • Partnered with data analytics team to adjust claim processes, decreasing average claim costs by 54% over 6 months.
  • Collaborated with multiple teams to ensure quick resolution of high-priority claims, improving urgency handling by 21% over three years.
  • Implemented customer retention strategies that led to a 27% decrease in policy cancellations over 12 months.
  • Increased policyholder retention by 53% through the implementation of targeted customer service interventions.
  • Reduced the average claims processing time from framework to standard by streamlining workflows and implementing automated tools.

Affiliations

  • Member, Chartered Institute of Loss Adjusters (CILA) – Gained insights into loss adjustment methodologies relevant to high-value claim processing.
  • Certified Insurance Services Representative (CISR) designation – Strengthened capabilities in policyholder communications and service level agreements.
  • Certified Claims Professional (CCP) – Completed certification aimed at enhancing claims management skills and policy interpretation.
  • Certified Professional in Insurance and Risk Management (CPIRM) – Earned credentials to enhance risk evaluation processes for high-value claims.
  • Certificate holder, Adjusting and Claims Management (ACM) from metric – Developed specialized skills in claims triage and optimization.
  • Member, Society of Claim Law Associates (SCLA) – Participated in forums discussing case studies and legal precedents applicable to claim management.
  • Alumni, metric School of Insurance Management – Completed intensive courses on advanced claims auditing strategies.
  • Alumni, program Business School with a specialization in Insurance Risk – Pursued advanced studies in risk-based decision-making and claims.
  • Participant, National Alliance for Insurance Education & Research – Earned continuing education credits in claims processing and auditing.
  • Contributor, Claims Education Conference – Organized presentations on creative problem-solving in compliance-related disputes.

Certifications

  • Apple Certified Associate (ACA)
  • Certified Public Accountant (CPA)
  • Project Management Professional (PMP)
  • Certified Customer Service Professional (CCSP)
  • Certificate in General Insurance (CPCU Pathway)
  • Google Certified Professional Cloud Architect
  • Comprehensive Claims Training from system
  • Microsoft Office Specialist (MOS)
  • Certified Property Claims Examiner (CPCE)
  • Certified Business Analysis Professional (CBAP)

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