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Skills

  • Claims processing accuracy
  • Auditing processes using software
  • Dispute escalation resolution
  • Customer service excellence
  • Collaboration with Legal Teams
  • Relationship development
  • Claims performance reporting
  • Claims categorization and review
  • Project organization
  • First Aid/CPR

Work Experiences

  • Achieved operational excellence in 2024.
  • Audited claims documentation for compliance.
  • Increased customer satisfaction by coming up with new ways to solve problems.
  • Achieved results after 6 months.
  • Advised senior management on efficient claims procedures that saved approximately $8 in operational costs annually.
  • Assisted in developing a customer-centered claims process, leading to a measurable 27% increase in positive feedback.
  • Advised senior management on claims procedures.
  • Increased profit margins by streamlining operations and workflow and negotiating competitive vendor contracts.
  • Accurately processed claims for ServiceNow.
  • Site evaluations, customer surveys, and team audits were all things I did.

Summaries

  • Accomplished Claims Associate.
  • Communicative and team-oriented, with Adobe Creative Suite expertise.
  • Achieved 72% reduction in errors.
  • Service-oriented and quality-focused, with 7 years of Miscellaneous experience and a track record of success.
  • Strategic planning in framework settings and risk assessment in performance reporting settings.
  • Vendor management Committed to identifying and leveraging opportunities for growth, with a proven ability to build effective teams.
  • ILR Claims Associate with risk assessment and performance reporting abilities.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • Proven track record of motivating spearheaded to achieve team, individual, and management goals.
  • Strong technical skills and experience in vendor management.

Accomplishments

  • Utilized advanced claims management software to assist in handling cases efficiently, producing a file closure rate of 71% above company targets.
  • Spearheaded cost-saving initiatives that lowered settlement payouts by an average of 59% while maintaining customer satisfaction.
  • Served as a critical point of escalation for complex ILR issues, achieving a 68% successful resolution rate of disputed claims.
  • Consistently achieved a claim approval rate of over 16% by meticulously evaluating and verifying all pertinent claim information.
  • Optimized documentation review processes, reducing claim verification time by 23% and improving team response times.
  • Led the resolution of 14 disputes between claimants and insurers, reducing potential litigation cases by 54%.
  • Contributed to a 74% reduction in claims backlog by refining workflow management and resource allocation.
  • Collaborated with underwriting teams to manage complex claims, securing settlements in 11 high-risk cases worth over $4.
  • Monitored and addressed litigation threats in high-value claims, reducing associated legal expenses by $13 annually.
  • Analyzed over 12 customer documents per day to assess the validity of ILR claims, ensuring accurate compensation decisions.

Affiliations

  • Participant, International Claims Association (ICA) annual conferences to stay current on global trends in claims management.
  • Affiliate, Professional Liability Underwriting Society (PLUS) – Engaged in ongoing professional development on high-value claims.
  • Member, Society of Insurance Research (SIR) – Engaging in industry-wide claims processing and data management trends.
  • Active participant in webinars hosted by the Association for Professional Insurance Women (APIW).
  • Member, Institute of Risk Management – Studied principles of risk identification and mitigation in claims processing.
  • Affiliate, Risk and Insurance Management Society (RIMS), leveraging continuous training and certification in claims management.
  • Participant, American Bar Association Tort Trial and Insurance Practice Section (TIPS), collaborating with fellow professionals on claims and mediation techniques.
  • Associate member, American Association of Insurance Services (AAIS), focused on regulatory intelligence and claims management.
  • Completed a course on Advanced Data Analytics Techniques for Claims Handlers, category, 2015.
  • Enrolled in Lean Six Sigma Green Belt Certification for claims and process improvement.

Certifications

  • Associate in Claims (AIC)
  • SHRM Certified Professional (SHRM-CP)
  • Cisco Certified Network Associate (CCNA)
  • Automotive Claims Adjuster Certification (ACAC)
  • Chartered Property Casualty Underwriter (CPCU)
  • Certified Insurance Adjuster (CIA)
  • American Academy of Financial Management (AAFM)
  • Certified Loss Adjuster (CLA)
  • CompTIA Security+
  • Project Management Professional (PMP)

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