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Skills

  • Supervision
  • Process improvement
  • Portfolio risk management
  • MS Office
  • Fraud detection & prevention
  • Claims Data Analytics
  • Communications
  • Complex Claim Management
  • Benchmarking performance
  • Regulatory compliance

Work Experiences

  • Collaborated with legal counsel to resolve disputes involving high-profile claims, securing $15 in compensation for clients while minimizing litigation costs.
  • Closed 7 cases ahead of schedule.
  • Examined claim forms and other records to determine insurance coverage.
  • Oversaw the delivery of initiative project by program team, which resulted in system.
  • Looked for industry trends on social media and through online sources.
  • Achieved savings of $6 for the company.
  • Assisted in the creation of company-wide claims handling standards, improving overall accuracy and reducing time-to-resolution by 6 months on average.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Collaborated with forensic experts and actuaries to assess liability for catastrophic claims, ultimately minimizing financial exposure for clients.
  • Had an excellent attendance record and was always on time for work.

Summaries

  • Oversee 15 cases per month with care.
  • Achieved liability reductions.
  • Collaborated with underwriters, actuarial teams, and external partners.
  • Consistently delivers operational efficiency improvements.
  • By applying all policies fairly, she is adept at balancing business and customer interests.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Achieved a 47% decrease in time-to-resolution.
  • Adept at fast-track claims processing.
  • High Profile Claims Specialist with 12 years of successful quality assurance and data analysis experience.
  • Consistently reduced external legal expenses by 39%.

Accomplishments

  • Managed end-to-end resolution of large-loss insurance claims, resulting in a swift resolution that mitigated client dissatisfaction rates by 31%.
  • Delivered customized presentations to executive stakeholders, analyzing claims trends and proposing data-driven strategies that led to a 23% reduction in claims incidents and payouts.
  • Contributed to litigation avoidance strategies by identifying key risk drivers in claims data, reducing litigation rates by 70% over a 2-year period.
  • Improved the claims cycle time by 40% in 2018 through the introduction of new documentation and reporting workflows, boosting overall efficiency.
  • Implemented machine learning claims analytics tools that led to an early detection of fraudulent claims, reducing fraud rates by 33% over 5 months.
  • Resolved product issue through consumer testing.
  • Established a training program on claims adjudication best practices, increasing overall claims processing accuracy by 84% across 16 teams.
  • Integrated new legal review protocols which improved compliance with industry regulations and reduced potential lawsuit risks by 71%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Effectively managed a portfolio of high-profile claims, ensuring timely and thorough documentation, which improved resolution times by 61% in 2021.

Affiliations

  • Certified member of the Chartered Insurance Institute (CII) specializing in high-profile claims negotiation and risk assessments.
  • Associate member of the American Insurance Association (AIA), contributing to advocacy for fair negotiable settlements in complex claims.
  • International Association of Administrative Professionals
  • Member of the National Association of Subrogation Professionals (NASP) for continuous learning in insurance claims recovery.
  • Association of Information Technology Professionals
  • Attended National Association of Insurance Commissioners (NAIC) workshops to maintain high standards of regulatory compliance in claims handling.
  • Active participant in the PLRB (Property and Liability Resource Bureau) Claims Conference to stay updated with litigation trends and regulatory updates.
  • Active participation in the American Bar Association (ABA) Tort Law and Insurance Practice community to broaden legal knowledge for claims resolution.
  • Society of Women Engineers
  • Freemason

Certifications

  • Certified Property Claims Adjuster (CPCA)
  • ServSafe
  • Legal Principles Claims Specialist (LPCS)
  • Litigation Claims Specialist Certification (LCSC)
  • Certified Claims Professional (CCP)
  • Associate in Claims (AIC) Certification
  • Xactimate Claims Professional Certification
  • Professional Risk Manager (PRM)
  • CompTIA A+ Technician
  • Certified Business Analysis Professional (CBAP)

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