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Skills

  • Organization
  • Benefit explanation
  • Conflict resolution and mediation
  • Inventory management
  • CCTV
  • Dispute resolution with minimal escalation
  • Caseload management exceeding industry KPIs
  • Data analysis in claims management
  • Administrative support
  • Project organization

Work Experiences

  • Kept my initiative knowledge up to date by doing strategic planning and vendor management.
  • Looked over policies to see what levels of coverage were appropriate and to help with approval or denial decisions.
  • Accurately calculated depreciation estimates.
  • Analyzed medical records and billings.
  • Assisted in the creation of framework procedures.
  • Achieved a 68% decline in follow-up inquiries.
  • Visited customers' homes to assess damage, such as fallen trees, leaking roofs, and other issues, in order to generate accurate cost estimates.
  • Explained loss coverage to policyholders, assisted them in itemizing damages, and arranged alternative living arrangements.
  • Assessed property damage in Portland.
  • Was in charge of all tasks delegated to me, including risk assessment and budget management.

Summaries

  • Looking forward to taking on a new challenge with a successful team.
  • Active leader with excellent communication and collaboration skills.
  • Achieved cost-effective resolutions.
  • Adaptable professional with a comprehensive understanding of insurance policies.
  • Budget management in metric settings and budget management in quality assurance settings.
  • Strong technical skills and experience in risk assessment.
  • Exceptional at juggling multiple goals in order to maximize efficiency and influence positive outcomes.
  • With hands-on experience, eager to learn new skills and advance knowledge.
  • Initiative and standard have a proven track record.
  • Standard, procedure, and metric are all available.

Accomplishments

  • Reduced claims cycle time by 73% through streamlined processes, resulting in improved overall customer satisfaction.
  • Effectively managed 3 catastrophic claims post-natural disaster, coordinating resources across two years to ensure rapid response.
  • Successfully leveraged bilingual abilities to assist French-speaking claimants, improving customer satisfaction scores by 33%.
  • Efficiently utilized Jira to gather and analyze loss data, significantly accelerating subrogation claim timelines.
  • Received 'Outstanding Service Award' for successfully auditing 7 claims files, uncovering $3 in discrepancies, and improving audit accuracy.
  • Assisted leadership in setting strategies for minimizing customer complaints during high-volume claim periods, improving retention by 58%.
  • Provided expert recommendations to senior management on complex claims worth more than $5, helping mitigate financial risks.
  • Recognized for resolving disputed claims in several months days on average, improving overall departmental metrics.
  • Led subrogation efforts that resulted in the successful recovery of $11, exceeding the company's target by 15%.
  • Managed and resolved high-dollar claims efficiently, ensuring compliance with state and federal regulations while reducing payout errors.

Affiliations

  • Licensed Adjuster, Massachusetts Department of Insurance Licensure, specialized in method
  • Participant, Ongoing Education on Microsoft Excel Implementation in Claims Handling
  • Volunteer, Meridian for catastrophe relief claims processing in disaster-prone areas
  • Affiliate, National Society of Insurance Premium Auditors (NSIPA)
  • Affiliated Member, National Association of Insurance Commissioners (NAIC)
  • Member, National Association of Mutual Insurance Companies (NAMIC)
  • Member, Federation of Defense & Corporate Counsel (FDCC) Insurance Section
  • Member, Council of Ethical Billing and Claims Practices (CEBCP)
  • Member, Risk and Insurance Management Society (RIMS)
  • Participant, Online Certificate Program in Xactimate and Estimating, method

Certifications

  • Association for Project Management (APM)
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Risk Analyst (CRA) - Beacon Labs
  • ServSafe
  • Fraud Claim Law Specialist (FCLS) - American Educational Institute (AEI)
  • Property and Casualty Insurance License - Oregon Department of Insurance
  • Advanced Claims Practitioner Certification - Society of Claim Law Associates (SCLA)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • ISO ClaimSearch Certified - Insurance Services Office (ISO)
  • Risk Management for Insurance Professionals Certificate - Cedar Works

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