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Skills

  • Process improvement
  • Advanced proficiency in Microsoft Excel and Google Sheets
  • Claims analysis and data reconciliation
  • Conflict Resolution and Complaint Handling
  • Customer relationship management (CRM) tools
  • Insurance policy data entry and verification
  • Project organization
  • Budgets
  • Advanced proficiency in Jira
  • Fraud detection and prevention strategies

Work Experiences

  • Coordinated daily administrative operations.
  • Compiled complex data into actionable insights.
  • Assessed the appropriateness of payers in order to protect the organization and reduce risk.
  • Collaborated with cross-functional teams to optimize the policy documentation process, leading to a 37% reduction in document errors.
  • Assisted with claims adjustments and escalations, contributing to a Excellence Award award for excellence in customer service.
  • Coordinated daily administrative operations, including answering policyholder inquiries, resolving complaints, and overseeing agent schedules to improve response times by 63%.
  • Created a quarterly report.
  • Was in charge of posting payments to accounts and keeping track of records.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Adjusted external vendor contracts for better terms.

Summaries

  • Working with stressed, confused, and upset people who need benefits information and supportive guidance to navigate method systems is one of my specialties.
  • Effective at managing phone calls, emails, letters, and in-person requests for assistance while adhering to initiative regulations and standard department guidelines.
  • Collaborative Insurance Verification Specialist with a track record of establishing rapport with patients and maintaining data integrity.
  • Committed to improving workflows and administrative processes, resulting in a measurable 66% reduction in paperwork-related delays and increased accuracy.
  • Collaborative team player with a proven ability to mentor administrative staff, improving departmental efficiency and reducing policy renewal times by 20%.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Clear understanding of risk assessment and vendor management as well as cross-functional collaboration training.
  • Adapted in supporting multiple facets of insurance administration, including policy renewal management and claims adjustments, while maintaining strict compliance with regulation policies.
  • Capable of managing high workloads in insurance environments while consistently achieving targets, including error-free data entry and claim reconciliation.
  • Professional with experience verifying insurance benefits and generating appropriate patient documentation.

Accomplishments

  • Led digitization initiative that transitioned 5% of legacy insurance documents to electronic format, improving retrieval efficiency by 43%.
  • Conducted regular audits of client files, ensuring that 45% of records were accurate and up-to-date after each audit cycle.
  • Resolved 8 customer service escalations related to claims issues, achieving a 36% client retention rate post-resolution.
  • Automated routine tasks such as client follow-ups and claim status updates using SAP, improving team efficiency by 18%.
  • Approved and processed customer cancellations and refunds in line with company policies, ensuring compliant handling and reducing future disputes by 81%.
  • Processed an average of 10 policy cancellations monthly, adhering to regulatory guidelines and ensuring compliance with industry standards.
  • Assisted the department in meeting monthly performance goals by reducing processing backlogs by 30% over one year.
  • Provided administrative oversight for internal compliance audits, producing reports used to inform executive-level decision-making and compliance improvement.
  • Supported underwriters by reviewing and inputting 9 policy applications per week, aiding in risk assessment and efficient policy issuance.
  • Drafted and routed approval requests for high-value commercial insurance claims, ensuring accuracy and compliance with underwriting guidelines.

Affiliations

  • Active Member, Chartered Insurance Institute (CII)
  • Project Management Institute
  • Association for Supply Chain Management (APICS)
  • Member, Association of Insurance Compliance Professionals (AICP)
  • Active member of the Professional Liability Underwriting Society (PLUS)
  • Lions Club
  • Regular attendee of the Insurance Accounting and Systems Association (IASA) annual conferences
  • Participant in Insurance Services Network (ISN) 2021
  • National Association of Social Workers
  • Certified member of Claims and Litigation Management (CLM) Alliance

Certifications

  • Property and Casualty Insurance License
  • Certified Professional Insurance Agent (CPIA)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Insurance Service Representative (CISR)
  • Apple Certified Associate (ACA)
  • Associate in Personal Insurance (API)
  • Project Management Professional (PMP)
  • CompTIA A+ Technician
  • Licensed Insurance Customer Service Representative (LICSR)
  • Certified Risk and Compliance Management Professional (CRCMP)

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