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Skills

  • Root cause analysis
  • Cross-functional collaboration
  • Client relationship management
  • Risk Assessment Analysis
  • Custom Adjudication Models
  • Fraud detection & prevention
  • Portfolio risk management
  • Organization
  • Coverage Analysis & Optimization
  • Benchmarking performance

Work Experiences

  • Achieved a 29% decrease in similar claims.
  • Achieved a 25% increase in positive client feedback post-event.
  • Authored process improvement reports.
  • Oversaw the delivery of initiative project by program team, which resulted in system.
  • Adapted to regulatory changes.
  • Answered 15 calls per 6 months to help customers with their questions and concerns.
  • Collaborated with external investigators.
  • 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.
  • Achieved a 20% reduction in pending claims backlog.

Summaries

  • Consistently reduced external legal expenses by 39%.
  • Excellent communication skills as evidenced by 2 years of experience interviewing experts, witnesses, and claimants in order to compile data.
  • Insurance adjuster who investigates and analyzes liability in the event of a personal, casualty, or property loss.
  • High Profile Claims Specialist with 12 years of successful quality assurance and data analysis experience.
  • Avoided the need for arbitration.
  • Collaborative and detail-focused professional.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Consistently delivers operational efficiency improvements by redesigning claims workflows, saving Vantage 4 annually and increasing client satisfaction.
  • Achieved a 84% improvement in client retention rate.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.

Accomplishments

  • Facilitated cross-functional collaboration with legal teams, forensic experts, and underwriters to resolve complex claims cases, reducing payout frequencies by 79%.
  • Collaborated with underwriting teams to reassess risk models and updated policies accordingly, saving Ironclad Systems $9 in potential overpayments.
  • Drove continuous improvement initiatives within the claims division, achieving operational savings of $13 while maintaining high service levels.
  • Effectively managed a portfolio of high-profile claims, ensuring timely and thorough documentation, which improved resolution times by 61% in 2021.
  • Implemented machine learning claims analytics tools that led to an early detection of fraudulent claims, reducing fraud rates by 33% over 5 months.
  • Successfully mitigated potential corporate exposure in large-scale litigation by working with subject matter experts, reducing legal expenses by $5.
  • Analyzed trends in high-value claims and initiated corrective workflows that led to a 67% reduction in long-term liabilities.
  • Led initiatives to streamline claims adjudication processes, resulting in a 37% increase in claims processed within target service level agreements (SLA).
  • Improved the claims cycle time by 40% in 2018 through the introduction of new documentation and reporting workflows, boosting overall efficiency.
  • Led a collaborative project with the IT department to implement a new claims management software, which reduced administrative load and shortened claim processing times by 69%.

Affiliations

  • Certified member of the Chartered Insurance Institute (CII) specializing in high-profile claims negotiation and risk assessments.
  • American Marketing Association
  • Participated in the National Insurance Crime Bureau (NICB) for staying informed on fraud prevention strategies and investigative tactics.
  • Engaged with the Risk and Insurance Management Society (RIMS), fostering knowledge of risk mitigation and regulatory compliance.
  • Affiliated with the Accident Compensation Corporation (ACC) Claims Management Certification Program for growing claims auditing and compliance proficiency.
  • Society of Human Resource Management
  • Collaborated with the Casualty Actuarial Society (CAS), enhancing skills in using data analytics for risk assessment and loss reserving.
  • Member of the National Association of Subrogation Professionals (NASP) for continuous learning in insurance claims recovery.
  • Society of Women Engineers
  • Regular attendee at the Association of Average Adjusters annual conference to gain insights into global standards for maritime and liability claims.

Certifications

  • Advanced Catastrophic Claims Certification (ACCC)
  • Certified Litigation Management Professional (CLMP)
  • Chartered Property Casualty Underwriter (CPCU)
  • Workers' Compensation Professional (WCP)
  • Certified Claims Professional (CCP)
  • Associate in General Insurance (AINS)
  • Associate in Risk Management (ARM)
  • Project Management Professional (PMP)
  • CompTIA A+ Technician
  • Certified Information Privacy Professional (CIPP) - Insurance Focus

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